Beating the Odds?


What are your odds of having high blood pressure? It is a simple question and all you have to do is ask your physician, correct?  As famed college football announcer Lee Corso likes to say, “Not so fast, my friend.”

The answer to your question may depend on which doctor you ask.  Your cardiologist may take your blood pressure, describe it as 131/81mmHg (the pressure is measured in how many millimeters it pushes a column of mercury, the symbol for which is “Hg”), and announce that you are hypertensive and need to start medicine.  Your internist may take your blood pressure, tell you it is 131/81mmHg, and say you are fine.  What is going on?

After many years of defining high blood pressure as anything equal to or above 140/90 mm Hg, the American College of Cardiology (ACC), with the American Heart Association (AHA) and others, introduced new blood pressure guidelines on November 13, 2017.

These new guidelines establish normal BP as less than 120/80.  A measurement of >120 to 130/80 is now "Elevated" -- not necessarily in need of medication, but clearly in need of a lifestyle change.  Stage 1 hypertension is > 130/80 and Stage 2 > 140/90 mmHg. Treatment of high blood pressure requires one or multiple drugs to control. According to the ACC’s data, the major benefit of more aggressive treatment of high blood pressure is a reduction of cardiac disease and mortality related to it.

Meanwhile, the American College of Physicians (ACP) that represents internal medicine doctors is not sold on the new ACC guidelines. In an Annals of Internal Medicine editorial, the ACP says that the new guidelines go too far and are short on scientific support.  The internists and the family physicians continue to recommend treating patients over 65 less aggressively in order to avoid the complications of pharmaceutical side effects.  The American Academy of Family Physicians (AAFP) also refused to endorse the new guidelines.

In a slightly uglier twist, a family physician in Baltimore objects to the ACC guidelines for a different reason: potential conflicts of interest.  The Maryland doctor discovered that six members of the ACC guideline committee had potential conflicts of interest because they failed to disclose relationships with companies that stand to gain from the change in guidelines.  Such omission, if substantiated, would be a serious breach of medical ethical standards by all involved.

What everyone agrees upon is that the new BP guidelines change the prevalence of high blood pressure in the United States from 32% of American adults to 46% of its adult citizens.  There will be a lot more patients receiving medication to lower their blood pressure, and there will be more side effects from those drugs.  The ACC et al, the ACP, and the AAFP all pay at least lip service to the need for lifestyle changes as an initial and continuing step in all patients with elevated, stage 1, and stage 2 hypertension.

In other words, the EHOP Health approach to potentially reversing disease, rather than simply managing it, becomes even more important to millions of Americans.  With proper help, many of these Americans that, with the stroke of a pen, went from normotensive to hypertensive can be returned to normal if they embrace a program like EHOP Health’s Journey 2 Health.

If the ACC guideline is correct, you have a 50/50 chance of becoming hypertensive.  The good news is that you can beat those odds.

We are here to help. 

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dooable health
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