A new study published in the Journal of the American Medical Association (JAMA), suggests the blood pressure guidelines go too far for low risk individuals, and the risk of harm outweighs the potential benefits.
The JAMA study was an extensive chart review of over 38,000 patients at low risk for heart disease who had stage two hypertension (blood pressure between 149/90 and 159/99) and were treated with blood pressure medications. Over an average follow-up time of almost six years, they found no reduction in the risk of cardiovascular disease events or risk of death with medication use. They did, however, find an increased risk for low blood pressure, fainting, and acute kidney injury among those treated with medications.
Based on these results, treating stage two hypertension in low risk patients tends to cause more harm than good.
According to TheNNT group, none were helped (preventing death, stroke, heart disease, or cardiovascular events) for those who received medication for the treatment of mild hypertension, but 1 in 12 were harmed (medication side effects and stopped the drug). Up to 40% of adults worldwide have hypertension, over half of which is classified as “mild.”
In 2012 meta-analyses of anti-hypertensive drug treatment compared to placebo or no treatment trials up until the end of 2011 found that, antihypertensive drugs used in the treatment of adults (primary prevention) with mild hypertension (systolic BP 140-159 mmHg and/or diastolic BP 90-99 mmHg) at a period of four to five years follow up, no differences were seen in mortality, cardiovascular events, CAD, or stroke. Treatment caused 9% of patients to discontinue treatment due to adverse effects.
A 2015 study found that people on hypertension drugs can have stroke risk almost 2.5-times greater than those without high blood pressure. Their study involved 26,785 participants 45 and older.
Calcium channel blockers reduce pancreatic insulin secretion and induce end-organ insulin resistance causing hyperglycemia.
Experimental models show that CCB toxicity shifts myocardial substrate preference to carbohydrates from free fatty acids; thus cardiac substrate delivery is impaired. Additionally, CCBs interfere with calcium-stimulated mitochondrial action and glucose catabolism; this results in lactate production and ATP hydrolysis contributing to acidosis.
All the above studies indicate, that drugs are not the solution. Actually, most drugs don’t benefit most of the patients who take them. Since we have no way of identifying those who will benefit, we are stuck treating the many to benefit the few. Its like buying a lottery ticket or buying insurance. Say, most of us pay for fire insurance for our homes, but not many houses burn down. We willingly pay premiums that may never benefit us because the cost of an uninsured disaster is so great. Paying premiums has no real harms apart from money spent while drugs inevitably have side effects.
By the way, according to the research paper published in American Heart Association Journal (dated 9 March 2018) the mortality rate drops when the doctors are absent from the ICCU. This means the chances of survival of the heart patient increases because of the absence of doctors, responsible to take care of patient. Its shocking but true.
Researchers at Harvard Medical School found that when heart specialists are away at academic conferences, the survival rate at their hospitals actually improves.
They believe that specialists who attend the meetings are more prone to using intensive interventions for their patients which may do more harm than good, rather than taking a more holistic approach.