Cardiologists are currently in a heated battle over blood pressure. For years, a blood pressure reading of 140 over 90 has been considered high; it is also the level at which most docs begin putting patients on blood pressure–lowering medication. But in December, a panel of top cardiologists recommended loosening those guidelines for older adults, telling doctors to prescribe medication only to people whose blood pressure is 150 over 90. This means that millions of Americans now on diuretics, beta blockers, ACE inhibitors – or a cocktail of high blood pressure drugs–may want to revisit their options. The panel argued that blood pressure–lowering drugs are expensive, can cause negative side effects, and interact badly with other medications.
By loosening the guideline, fewer people would need these drugs and some could even lower their dosages. The panelists also said there wasn't sufficient evidence to show that medicating people at the 140-over-90 mark did much good. The bottom line: Go to your doctors with these new guidelines and have a conversation.
Not everyone is on board with the new recommendation. The American Heart Association doesn't like it. Neither does the American College of Cardiologists. Even the National Heart, Lung and Blood Institute – the government group that originally commissioned the panel – won't endorse lowering the threshold for treatment. "Millions of Americans have high blood pressure, and more than one-third of them don't know it," says Dr. Mariell Jessup, president of the American Heart Association. The problem, she claims, is that this panel was bound by the Institute of Medicine's rigid rules of looking only at certain types of data. Jessup doesn't think the studies the panel examined were conclusive enough to warrant changing the current guidelines.
Jessup admits that blood pressure–lowering drugs are expensive and do produce unwanted side effects, such as fainting and falls among older people and low libido in young and middle-aged men. And the more medications you're on, the greater likelihood they'll interact with one another. Still, "hypertension kills,” says Jessup. "Even now, one in three Americans will die from cardiovascular disease."
The bottom line: If you're on one or more high blood pressure medications, now's a good time to talk to your doctor about the pluses and minuses – especially if you're eating right, exercising, and making every effort to get healthy outside of using drugs.