The People's Perspective on Medicine

Aggressive Blood Pressure Treatment Can Cause Deadly Dizziness

Aggressive blood pressure treatment may lower the likelihood of a stroke but blood pressure can drop so much that a person faints or falls from dizziness.
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Hypertension is frequently referred to as the silent killer. That’s because it has few symptoms but greatly increases the likelihood of strokes, heart attacks and kidney damage.

Does It Make Sense to Treat Moderately High Blood Pressure?

Although there is good evidence that treating really high blood pressure with medications can save lives, the rewards are less clear when blood pressure is in the moderately elevated range (systolic at 159 or below; diastolic at 99 or lower). A systematic review of clinical trials failed to show a benefit of drug treatment for patients without pre-existing heart disease and with only mild to moderate hypertension (Cochrane Database of Systematic Reviews, Aug. 15, 2012).

New guidelines have raised the cutoff for treating blood pressure in people over 60. Instead of trying to get everyone in this age group to a systolic reading under 140, the new recommendations suggest 150 as a more appropriate trigger.

Some doctors are outraged at this change and believe loosening the guidelines will lead to unnecessary deaths. What they may not be taking into account, however, is the risk of aggressive blood pressure treatment itself.

Aggressive Blood Pressure Treatment Carries Risks:

A new study found that older people on blood pressure pills are more prone to dizziness and falls (JAMA Internal Medicine, April, 2014). Older people who had already fallen were especially vulnerable. Such falls can lead to hip fractures or head injuries and the researchers concluded that these accidents were as likely to be deadly as heart attacks or strokes.

Here is a story from one reader:

“I started taking a blood pressure medicine years ago, even though my blood pressure and kidneys were fine. My doctor wanted to protect my kidneys, just in case there might be a problem. I have diabetes and diabetics are more prone to have kidney problems.

“I had only mild side effects with the medication. In 2007 I started having higher blood pressure numbers, like 135/75, so my dosage was doubled. I became dizzy as a side effect.

“For five years I have had dizziness; recently it is much worse. Sometimes I fall down or stagger with dizziness. I stopped my anti-hypertensive drug for two weeks last year and my dizziness was so much better. I could walk normally!

“What a relief, but my blood pressure increased into the 140s. While using a full dosage of the medicine my BP is about 120/58. If I use a half dosage my BP is more like 135/65. Is it better to have a reading of 135/65 and very little dizziness or lots of dizziness at 120/58? I have never had any kidney problems, and I am skeptical about the benefits of the higher dosage.”

We also worry about aggressive blood pressure treatment that results in dizziness or unsteadiness. This reader and others might benefit from using non-drug approaches to lowering blood pressure, either in combination with the medication or (with medical supervision) instead of drugs. There is a range to choose from in our Guide to Blood Pressure Treatment.

On the Other Hand:

Research findings became even more confusing when the SPRINT trial was stopped early because the results were striking. In this study, more than 9,000 people at high risk of cardiovascular complications were less likely to experience a heart attack or stroke if aggressive blood pressure treatment got their systolic measurement down to around 120 instead of 140 (New England Journal of Medicine, Nov. 26, 2015). You can read what we wrote about the SPRINT trial here. But even in this much applauded study, people who received the most aggressive blood pressure treatment were more likely to faint or lose consciousness. We think the potential risks still need to be considered.

Revised 3/17/16

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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Who paid for the SPRINT study? A drug company that sells blood pressure meds?

How do I indicate that I would like to receive all future comments about this topic?

i am eating foods that lower my bp and loss weight.Bp meds droped my blood pressure to low .

Hi again: Still waiting for an answer as to what is a JUJUBES and where do you get them? Thanks in advance.

I would definitely talk to my cardiologist.

About 12 years ago, extremely high blood pressure (350/240) caused severe headaches and three brain bleeds. I have been on HBP ever since. I now take Sular.
Recently I’ve had several episodes of plummeting blood pressure (67/54) with weakness and dizziness. I have a routine appointment with my GP in two months. Should I ask for an earlier appointment? Has anyone else had this problem of low blood pressure?
People’s Pharmacy response: We suggest you contact the doctor’s office and describe your episodes of dizziness and weakness along with a sudden drop in blood pressure. S/He will then be in a position to determine if you need to be seen before your regular appointment.

Some comments: The most recent “Sixty Minutes” was about a massive longitudinal study of “the very old,” 90 years plus. They’d been followed for about 40 years and extensively tested and questioned every year re nutrition, meds, habits, lifestyle choices, etc.
One very interesting and surprising finding (out of MANY!) was that people with “slightly high blood pressure” definitely lived longer when all other factors were controlled for. They said these people did much better than people with normal, low or very high blood pressure. SO: how about that?! Sorry I don’t have more info on the exact BP numbers.
Also: Those horrible beta blockers don’t just cause dizziness; they absolutely cause muscle weakening. So you can’t walk as far or as fast, or do other activities that promote good health and longevity: A double-whammy!
Also: I totally agree with Torrence’s comment (the 1st one in the chain) re increased longevity in seniors from other countries that don’t have the “luxuries” and technology that we have, i.e., “none of the anxiety and pressure” that come with the use of these things. I believe this “anxiety and pressure” comes not so much from the use of technology itself (tho it can sure be frustrating) — but because the more activities and interactions that TECHNOLOGY does FOR us, the fewer things we do for ourselves in real-time/real-space. These activities and interactions are what keeps us independent and autonomous, gives us a healthy sense of identity and competence, and teaches us about the world, and others, and therefore ourselves in relation. THAT’S why Einstein said TECHNOLOGY WILL PRODUCE A SOCIETY OF IDIOTS… unhealthy, anxious ones, I might add. (That said, I do like my computer and iPhone. But I like natural life better!)

Yes, I’d like more info about jujubes, too please.

Hi Catnarina: Just what is a jujubes? I’d like to try this but not sure what it is or where to get it. Thank you.

I was also put on metoprolol (sp) and didn’t do well on it. A cardiac monitor ruled out Atrial Fibrillation so the premature beats are called PAC or PVC and are common and very benign according to many doctors I’ve spoken with. I would question the meds and perhaps you can go on Atenolol which I’ve been taking for years and managing reasonably well. Check out the NIH website or Google/ Bing for more info.
As they advise, don’t stop any meds without first consulting your cardiologist. I like to question then docs. here in the Boston area, and although they may have an aire of status, my experience has been that if you do a little research they will take time to listen.

I have diabetes too and for years took diovan, had dizzy attacks. At first I thought it was positional hypotension, it would particularly happen when getting out of the car. My bp at the doctor’s office was usually in the teens over the low 60s. On top of the diovan, I was, and am, taking spironolactone and triamterene HCTZ, two diuretics, to hold onto minerals, since 2002, other reasons before that. The diovan was to protect my kidneys, not for any further action on bp. I moved away for several months, the dizziness worsened, so, on my own, I stopped the diovan, tapering off. When I came back and gave my list of meds to my new doctor, neither diovan nor lipitor were included. I still have occasional dizziness, tho not as bad; however, I take a slew of meds and am missing several parts. I do not have high bp nor any signs of heart disease; have not had a stroke. Am 76, now have one kidney, doing its best, as am I.

Thanks for the tip. I have hypertension 170/70 taking terazocyn 2mg & hcyz 25mg feeling a little dizzy thought ginger will relieve but not much NOW I know! I’ll talk to my MD. Thanks again.

I have been on the NIH SPRINT blood pressure study for about 2 years, and I was put in the group that aggressively treats with a goal to reach a BP of 120/80+-. That is usually achieved with an increase in meds however because i have a history of heart disease, an angioplasty in 1998 and occasional PAC’S The doc. insists on my maintaining the higher dose. Possible side effects are a slow pulse usually below 60pbm and it takes me a while to get my energy up when I exercise. I’m 78 and in otherwise reasonably good health. I am thinking of dropping out of the SPRINT program, but since the side effects are not as severe as described by a previous writer, I wonder if that is wise.

OK… This is happening to me. I was diagnosed with HB after facing 159 top number only once or twice. Mostly it stayed below 130… they put me on metropolol and now I have fatigue, and light headiness and often my bottom numb is as low as 43…… my pulse also is irregular.
I don’t get it.
Should I speak to my cardiologist about this or just go on taking the medication and planning more naps?

Would like comments on this

I lowered my borderline high blood pressure to a normal one by eating 3 dried jujubes every day. It only took a few weeks.

Over the many years that I am practicing medicine, medical opinions had often the character of a yo-yo.
For example opinions about diet, salt consumption, ideal weight, blood pressure treatment, diabetes diagnosis and treatment, and not to forget the cholesterol “issue”.
The ugliest word that arose was: EBM [evidence based medicine]
The [so useful!] website of the Graedon’s could close down if it all had to be evidence based.
The statements and opinions about blood pressure treatment seem to me again based on just statistics………patient is not important.
If a patient with a certain blood pressure feels much better when treated……….then please TRY treatment.
[Of course do everything to optimize blood pressure by natural means.]
This could be even 130 systolic……….some patients feel much better on 110.
If treating 140-150 diastolic makes him “sick” then think twice and leave it as it is.
Don’t be a robbot-doctor [evidence based]
How often can raising a low potassium level not be a the difference between well- and not-well feeling!

You sound like the the kind of doctor that the world should have a lot more of! Thank you for your thoughts!

Thank you for this article. I made an appointment to see my doctor due to dizziness. I now have a definitive answer for the question I will ask. I thought the dizziness was a figment of my imagination. Thank you again.

I am 74 and had a mild stroke 2 years ago which left my right side slightly numb with pins and needles in my fingers and toes. I was put on 40mg simvastatin, 10mg vamlo and 4mg coversyl for more than a year in which time my total cholesterol dropped to below 2 and my b/p dropped to 110/55. Because of persistent coughing, I was given a non-statin call ezetrol and the dosage was reduced to only 5mg. My coughing has stopped and my total cholesterol is a steady 4.2 (after fasting) For my b/p I now take 5mg vamlo only and my morning reading is remaining at around 110/58. However, I do feel slightly unsteady when I wake up or when I get up after sitting down for 10-20 minutes or more.
I am a type 2 diabetic and am taking 250mg Metformin twice a day, once after breakfast and dinner. My blood glucose (first thing in the morning) is averaging around 5.8+/-0.3.
What I am interested to know is that is my b/p too low and do I need to take vamlo much longer, and will my numbness go away when my b/p remains so low?
Thank you.

There was some tests done some years ago on people in other countries that were in their 80’s and 90’s. They found out their BP and Cholesterol were both moderately high, but they still worked in their fields and had no signs of any medical problems. ONE BIG DIFFERENCE between us and them is they had NO TV’s or computers and phones of any kind, and NONE of the luxuries we have. They lived very simple lives and lived as a family in simple houses. They had what none of us have…. NO ANXIETY and nerves from pressure in the way we live. Does that tell you anything? The idea of more, more and more… and especially MORE MONEY, is out biggest problem in life. Think about it!!!!!!!!!!! OH, and I’m just as guilty as you are! Isn’t it sad that we deserve just about everything we get?

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