New blood pressure guidelines could put lives at risk, say experts

April 16, 2018

The recent recommendations from American College of Cardiology and the American Heart Association are as follows:

Changing the diagnostic and treatment thresholds for hypertension could put people at risk in three ways, say the University of Sydney and Bond University authors of the report.

"First, wider disease definitions mean more people are labelled as unwell, even if they have low risk of a disease," said the report's lead author, Dr Katy Bell of the University of Sydney.

"Labeling a person as having hypertension increases their risk of anxiety and depression, as compared to the risk for people with the same blood pressure who aren't labelled as hypertensive.

"Second, it means more people may experience serious adverse effects from treatments.

"Third, in countries without universal health coverage, such as the United States, people newly diagnosed with hypertension may face difficulties gaining insurance coverage for a 'pre-existing' condition."

Report co-author, Bond University Professor Paul Glasziou said: "The ACC/AHA guideline follow an established pattern in the medical specialties, where disease definitions are more often widened than narrowed.

"Systolic blood pressure has poor reproducibility, with a 10mmHg standard deviation for repeat measurements between clinics," he added.

"Since a large proportion of all adults have a 'true' systolic blood pressure near the threshold of 130 mm Hg, the inherent variability of blood pressure increases the potential that hypertension will be diagnosed."

The report says 80 per cent of people with newly diagnosed hypertension under the ACC/AHA guideline would get no expected benefit in terms of cardiovascular disease risk reduction by lowering their blood pressure. Eleven per cent would get a marginal benefit and nine per cent would get a larger benefit.

However, the 2017 ACC/AHA guideline would classify an additional 13.7 percent of all adults as having hypertension - 31 million additional people in the United States as having hypertension, and around 2.4 million additional Australians.

For the majority of these people, who are at low risk and not recommended for drug treatment (about 25 million), the authors say doctors should not label them as having hypertension.

"Doctors should continue to support healthy choices with regard to diet and physical activity regardless of whether a patient's systolic blood pressure is above or below 130 mmHg," said Bond University co-author, Professor Jenny Doust.

"When there is a question of starting blood pressure medication, the risk of cardiovascular disease should be estimated using a reliable risk calculator and the potential benefits and harms discussed with the patient".
-end-


University of Sydney

Related Blood Pressure Articles from Brightsurf:

Children who take steroids at increased risk for diabetes, high blood pressure, blood clots
Children who take oral steroids to treat asthma or autoimmune diseases have an increased risk of diabetes, high blood pressure, and blood clots, according to Rutgers researchers.

High blood pressure treatment linked to less risk for drop in blood pressure upon standing
Treatment to lower blood pressure did not increase and may decrease the risk of extreme drops in blood pressure upon standing from a sitting position.

Changes in blood pressure control over 2 decades among US adults with high blood pressure
National survey data were used to examine how blood pressure control changed overall among U.S. adults with high blood pressure between 1999-2000 and 2017-2018 and by age, race, insurance type and access to health care.

Transient increase in blood pressure promotes some blood vessel growth
Blood vessels are the body's transportation system, carrying oxygen and nutrients to cells and whisking away waste.

Effect of reducing blood pressure medications on blood pressure control in older adults
Whether the amount of blood pressure medications taken by older adults could be reduced safely and without a significant change in short-term blood pressure control was the objective of this randomized clinical trial that included 534 adults 80 and older.

Brain blood flow sensor discovery could aid treatments for high blood pressure & dementia
A study led by researchers at UCL has discovered the mechanism that allows the brain to monitor its own blood supply, a finding in rats which may help to find new treatments for human conditions including hypertension (high blood pressure) and dementia.

Here's something that will raise your blood pressure
The apelin receptor (APJ) has been presumed to play an important role in the contraction of blood vessels involved in blood pressure regulation.

New strategy for treating high blood pressure
The key to treating blood pressure might lie in people who are 'resistant' to developing high blood pressure even when they eat high salt diets, shows new research published today in Experimental Physiology.

Arm cuff blood pressure measurements may fall short for predicting heart disease risk in some people with resistant high blood pressure
A measurement of central blood pressure in people with difficult-to-treat high blood pressure could help reduce risk of heart disease better than traditional arm cuff readings for some patients, according to preliminary research presented at the American Heart Association's Hypertension 2019 Scientific Sessions.

Heating pads may lower blood pressure in people with high blood pressure when lying down
In people with supine hypertension due to autonomic failure, a condition that increases blood pressure when lying down, overnight heat therapy significantly decreased systolic blood pressure compared to a placebo.

Read More: Blood Pressure News and Blood Pressure Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.