white coat hypertension, blood pressure, blood pressure measurement, blood pressure and dementia, highly variable blood pressure

How low should you get blood pressure to go? One group of researchers examined the cost effectiveness of intensive blood pressure control.

Is Intensive Blood Pressure Control Worth the Effort?

Two years ago, the Systolic Blood Pressure Intervention Trial (SPRINT) showed that lowering systolic pressure below 120 was better at preventing heart disease, complications and premature death than aiming for 140. However, the scientists running SPRINT were very careful about selecting patients who would get the most benefit from intensive blood pressure control.

In addition, questions remained about whether the difficulties of achieving such low blood pressure and the potential side effects people might suffer would make this intervention too costly. In many cases, volunteers needed to take several medications in order to get systolic blood pressure even close to 120.

Intensive Blood Pressure Control Is Considered Cost Effective:

The computer simulation the scientists developed suggests that intensive control would cost approximately $47,000 per quality adjusted life year. That meets the criterion of being less that $50,000 per QALY. An accompanying research study concluded that that there were no significant differences in patient satisfaction between those under intensive therapy and those under standard care.

Bress et al, New England Journal of Medicine, Aug 24, 2017

Get The Graedons' Favorite Home Remedies Health Guide for FREE

Join our daily email newsletter with breaking health news, prescription drug information, home remedies AND you'll get a copy of our brand new full-length health guide — for FREE!

  1. Ines
    Reply

    I remember learning about 100+age for optimum BP back in nursing school during the 1960’s, but not much since then. I’ve been on numerous combinations of BP meds for over 30 yrs now. A combination potassium sparing HZT, lisinopril, atenolol, amlodipine right now with an occasional clonidine if the systolic gets near 200 & diastolic above 110.

    It’s very erratic, no rhyme or reason, if systolic gets much below 110/??? I faint. The diastolic, more often than not, is higher than “normal”. What’s optimal for one is not necessarily so for another.

    • Ines
      Reply

      I don’t understand what you mean by “moderation”.

  2. Ines
    Reply

    I remember learning about 100+age for optimum BP back in nursing school during the 1960’s, but not much since then. I’ve been on numerous combinations of BP meds for over 30 yrs now. Diazide, lisinopril, atenolol, amlodipine right now with an occasional clonidine if the systolic gets near 200 & diastolic above 110.

    It’s very erratic, no rhyme or reason, if systolic gets much below 110/??? I faint. The diastolic, more often than not, is higher than “normal”. What’s optimal for one is not necessarily so for another.

  3. Tony
    Fl.
    Reply

    10 years ago or so, I was diagnosed with essential hypertension, and prescribed 40 mlg of Quinapril, which got my B/P down to the pre-hypertension area…
    Of recent I’ve been taking 2x 500 mlg of Krill Oil and 2x 1000 mlg of
    L-Arginine per day..along with the Quinapril,,,
    My B/P has dropped below the recommended 120/80 level and to the point that my Dr. recommended stopping the Quinapril to see what would happen,,
    I haven’t done it yet, but think I’ll try it soon

  4. Garry TM
    Reply

    For consideration, the latest and final report of the Joint National Committee on Blood Pressure [ number 8] :

    Recommendation 1 (Grade A recommendation) states that in the general population aged ≥60 years, initiate pharmacologic treatment if BP is ≥150/90 mmHg and treat to a goal BP of <150/90 mmHg. Recommendation 2 states that in the general population <60 years, initiate pharmacologic treatment to lower BP at diastolic blood pressure (DBP) ≥90 mmHg and treat to a goal DBP <90 mmHg (For ages 30-59 years Grade A recommendation; for ages 18-29 years Grade E recommendation). Recommendation 3 (Grade E) states that in the general population <60 years, pharmacologic treatment should be initiated if systolic blood pressure (SBP) is ≥140 mmHg and treat to a goal SBP <140 mmHg.

    There are indications that some doctors are unaware of Report #8 and continue to use older reports for guidance. Different ages and health conditions require variable BPs. We are responsible for our own health. At the least, before accepting BP drugs, we ought to ask and compare our doctor's advice to the latest JNC report referenced above.

  5. TERRY
    Reply

    My dr. Had me on amlodipine and metoprolol and could not figure out why bp was not lowering. Then referred to nephrologist who did aldosterone/renin ratio blood test that told him I had hyperaldosteronism. Took me off all meds except spironolactone (Aldactone – 50 mg./day). He said the other drugs did not help with my condition. Does anyone else have this? Give details. It was once considered rare.

  6. Patty
    Jacksonville, FL
    Reply

    I participated in the SPRINT study for 4 years. I’m now 75 years old. The medications I was given were strong and caused me so many side effects . I developed a severe rash along with eczema, loss of hair and lichen planus of the gums and scalp. I completed the study and stopped the medications after many visits to the dermatologist. I’ll take my chances with a healthy lifestyle before I go through the misery of taking those medications again.

  7. Ann
    Reply

    These numbers are totally wrong.. they were set in place in 1977 with the approval of the World Health Organization. Since doctors really don’t understand bp at all, it’s easy to change numbers and put people on more medications to push the numbers down and it still doesn’t work in most cases.. WHY, because the numbers are wrong that’s why.. they are fighting against nature… Correct bp is 100 + age.. Don’t tell me otherwise.. I don’t believe it.

    • Sally
      WA
      Reply

      Can you cite research to back this up?

  8. Cheoni M
    Liverpool
    Reply

    I was taking Lansoprazole for more than 7 years.this medicine doesn’t work.when taking them for the effects will start four years after . It’s increase more acidic in your stomach early in the morning,then night burping ,hiccups or chocking or coughing and constipation.l went to see GP and explained but nothing change only to increase the dose.when my stomach was hot I usually cooling down the cold milk. I stopped Lansoprazole for a year and half and continue taking cold milk.

    What I notice also develop back pain,joints pain, difficult walking in morning. I went back to Gp the treatment was blood test.blow small tubes then been sent to the laboratory. All results came negative.then l come across someone told me same story. He end up in hospital given Iv pantoprazole a dose after a does due acidosis. I phoned my Gp to prescribed pantoprazole which I started talking last week. All aching ,high acid gone even hot in my stomach even l miss a dose no acid increase.Lansoprazole should be banned.the only problem left is coughing but not much. I remember reading about it long time ago on this web.

    • Muddy
      Reply

      Where did you read about 100+age?

What Do You Think?

We invite you to share your thoughts with others, but remember that our comment section is a public forum. Please do not use your full first and last name if you want to keep details of your medical history anonymous. A first name and last initial or a pseudonym is acceptable. Advice from other commenters on this website is not a substitute for medical attention. Do not stop any medicine without checking with the prescriber. Stopping medication suddenly could result in serious harm. We expect comments to be civil in tone and language. By commenting, you agree to abide by our commenting policy and website terms & conditions. Comments that do not follow these policies will not be posted.

Your cart

Total
USD
Shipping and discount codes are added at checkout.