More and more people are being diagnosed with high blood pressure and started on treatment. This triggers the cynic in a lot of us (myself included) and we wonder who’s behind this and what they are getting out of it…

Here are a couple of statements that we come across a lot:

“Blood pressure goes up naturally as you get older. So blood pressure targets should increase with age as well.”

“Blood pressure targets keep being lowered so the drug companies can sell more drugs. This is designed to turn healthy people into patients.”

There is truth in both of these statements, but you won’t be surprised to hear that they bear further examination. I wrote about the first statement in an earlier post. Let’s look at the second statement here.

 

“Blood pressure targets keep being lowered so the drug companies can sell more drugs. This is designed to turn healthy people into patients.”

Do blood pressure targets keep being lowered? In general, yes, each time new guidance is published they tend to go down rather than up! And yes, this will mean more people will be diagnosed with high blood pressure and potentially more people will be given blood pressure medication.

Will this turn healthy people into patients? Unfortunately, it often does. We agree that this is a bad thing. We view blood pressure as just another measure you might take of your body, like your height, weight or shoe size. If you consider being overweight, this also increases the risk of various illnesses just like having high blood pressure. But most people don’t feel they become a patient when they step on the scales and see that they are overweight.

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So why should high blood pressure be any different? The reasons are complex but have a lot to do with how much control people feel they have over blood pressure. Currently it is mostly doctors and nurses who dictate what you should do with your blood pressure. At YourPressure we are working to give control back to you. There is evidence that this can bring significant health benefits.

But why do blood pressure targets keep being lowered? Often this is due to new evidence that shows that lower blood pressure reduces the risk of heart attacks and strokes even further. However, recent changes have often been specific to certain groups of people. For instance, if you have diabetes then we know that there is benefit in lowering your blood pressure further than the rest of the population. These different targets for different people have lead to a fair bit of confusion among the medical profession themselves!

High blood pressure is also split into ‘stage 1’ and ‘stage 2’ depending how high it is. Most people have ‘stage 1’ high blood pressure and this does NOT require treatment unless you have other conditions or findings on certain tests (such as ECG changes or changes to the blood vessels at the back of your eyes). This approach of different treatment for different people is good in that those who will benefit most are treated, whilst the rest of us can be left alone. But the complexity also increases confusion. We suspect that a significant number of people may be over-diagnosed or over-treated for high blood pressure.

The final point, as I wrote in my last post, is to remember that we are talking about ‘targets’. Literally, something to aim for. Many people won’t get there and yet there is still a lot of benefit to be had by making small reductions in blood pressure. I won’t repeat it all here.

So in summary, yes, blood pressure targets do keep being lowered. But that is often for good reason as certain groups are found to benefit from lower targets. But remember, they are targets, so just something to aim for. Problems can arise when complex targets are not applied to the right people so they are over-treated. We hope this can be improved by returning blood pressure control to people and away from the medical profession. Our upcoming mobile app is our first step in trying to achieve this.

 

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