Americans with blood pressure of 130/80 or higher should be treated, down from the previous trigger of 140/90, according to new guidelines announced on Monday by the American Heart Association and the American College of Cardiology. The guidelines do not change the definition of normal blood pressure as 120/80 or lower.
At the new cutoff, around 46 percent, or more than 103 million, of American adults are considered to have high blood pressure, compared with an estimated 72 million under the previous guidelines in place since 2003. High blood pressure accounts for the second-largest number of preventable heart disease and stroke deaths in the United States, second only to smoking.
Potentially deadly high blood pressure can be brought under control with a wide array of medications, many sold as relatively inexpensive generics. The drug classes include angiotensin receptor blockers, such as Novartis AG’s Diovan, calcium channel blockers, like Pfizer Incs’s Norvasc, ACE inhibitors, including Pfizer’s Altace, and diuretics, such as Merck & Co Inc’s Hyzaar.
But the drugs have side effects and the new guidelines emphasize lifestyle changes including weight loss, diet and exercise as the first tool for combating hypertension. “I think this will encourage both patients to adhere to recommendations but also clinicians to be more vigorous in their attempts to prescribe lifestyle changes,” said Dr. Pamela Morris, chair of the ACC’s committee on prevention of cardiovascular disease.
Lifestyle modifications are the cornerstone for treatment, but the guidelines also stress that patients assessed to be at high risk of cardiovascular problems will be started on medication. A large, government-sponsored study of hypertension patients aged 50 and older showed in 2015 that death from heart-related causes fell 43 percent and heart failure rates dropped 38 percent when their systolic blood pressure was lowered below 120 versus those taken to a target of under 140.
But patients in the 120 systolic blood pressure group had a higher rate of kidney injury or failure, as well as fainting. Concerns about those side effects, as well as the fact that the close monitoring seen in a clinical trial is hard to replicate, led the AHA, ACC and other groups to select the 130 systolic blood pressure target.
The new guidelines also emphasize the importance of accurate blood pressure measurements, using an average of different readings at different times.
Adults with blood pressure of 130/80 “already have double the risk of heart attack compared to someone in the normal range,” said Dr. Paul Whelton, professor at Tulane University School of Public Health and Tropical Medicine and School of Medicine in New Orleans and lead author of the new guidelines. “It doesn’t mean you need medication, but it’s a yellow light that you need to be lowering your blood pressure, mainly with non-drug approaches.”
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| Gentle persuasion from big phermas basically has nudged US doctors to lower old-guide 140/90 to 130/80. |
30 Million Americans Were Just Diagnosed With High Blood Pressure, Here's Why? 30 million Americans who woke perfectly healthy yesterday morning are now suddenly in need of expensive hypertension treatments after the American Heart Association and the American College of Cardiology decided to lower the definition of "high blood pressure" to 130/80 from the previous trigger of 140/90.
According to Reuters, the change means that nearly 50% of American adults, or roughly 100 million people, now suffer from high blood pressure. Americans with blood pressure of 130/80 or higher should be treated, down from the previous trigger of 140/90, according to new guidelines announced on Monday by the American Heart Association and the American College of Cardiology.
At the new cutoff, around 46 percent, or more than 103 million, of American adults are considered to have high blood pressure, compared with an estimated 72 million under the previous guidelines in place since 2003.
Not surprisingly, these new guidelines are expected to be a boon for pharma giants like Merck, Pfizer and Novartis who supply the world's expensive hypertension medications. Potentially deadly high blood pressure can be brought under control with a wide array of medications, many sold as relatively inexpensive generics.
The drug classes include angiotensin receptor blockers, such as Novartis AG’s Diovan, calcium channel blockers, like Pfizer Incs’s Norvasc, ACE inhibitors, including Pfizer’s Altace, and diuretics, such as Merck & Co Inc’s Hyzaar.
But the drugs have side effects and the new guidelines emphasize lifestyle changes including weight loss, diet and exercise as the first tool for combating hypertension. “I think this will encourage both patients to adhere to recommendations but also clinicians to be more vigorous in their attempts to prescribe lifestyle changes,” said Dr. Pamela Morris, chair of the ACC’s committee on prevention of cardiovascular disease.
Of course, perhaps a slight, artificial
"tweaking" of their addressable market was exactly the right cure for
what's been ailing Merck's stock of late.
(Blogger's Notes: From my own experience as a chronic hypertensive man - having hypertension, even a mild one, is a very expensive curse. Once one is on hypertension-pills one will never pill-free again as one's doctor raises the pill-strength gradually to control the raging hypertension. If one stops taking the pills one will suddenly have a head-spin so bad one could not get out of the bed or stand up without collapsing. Believe me that had been my true nightmare for nearly 15 years till 2012.
At the beginning of my move to New York in late 2011, to get a script for pills, I had to see a doctor once every three months at a cost of minimum $200. And the pills costed at least $100 a month. I was so sick of it and finally decided to join Venderbilt YMCA Gym in E-47th Street in mid 2012. $60 a month and six months, of daily free weights & boxing & swimming, later I became pill-free again after nearly 15 years of taking them. Only problem is now I am a serious Gym-junkie with overly-wide massive shoulder and rock-hard six-pack at the ripe old age of 62, Ha-Ha-Ha.)
(Blogger's Notes: From my own experience as a chronic hypertensive man - having hypertension, even a mild one, is a very expensive curse. Once one is on hypertension-pills one will never pill-free again as one's doctor raises the pill-strength gradually to control the raging hypertension. If one stops taking the pills one will suddenly have a head-spin so bad one could not get out of the bed or stand up without collapsing. Believe me that had been my true nightmare for nearly 15 years till 2012.
At the beginning of my move to New York in late 2011, to get a script for pills, I had to see a doctor once every three months at a cost of minimum $200. And the pills costed at least $100 a month. I was so sick of it and finally decided to join Venderbilt YMCA Gym in E-47th Street in mid 2012. $60 a month and six months, of daily free weights & boxing & swimming, later I became pill-free again after nearly 15 years of taking them. Only problem is now I am a serious Gym-junkie with overly-wide massive shoulder and rock-hard six-pack at the ripe old age of 62, Ha-Ha-Ha.)