According to a new study, researchers estimated one out of every three U.S. adults has high blood pressure that should be treated with medication, under guidelines recently adopted by the two leading heart health associations. The American College of Cardiology and American Heart Association redefined high blood pressure, based on new evidence supporting a lower threshold. The new study was published in JAMA Cardiology.
A new study reports Under the new guidelines, nearly 46 percent of U.S. adults now would be considered to have high blood pressure. Further, 36% would be recommended for blood pressure medication, the study authors said. That means the number of American adults diagnosed with high blood pressure would grow to 105 million from 74 million, and those who should be taking medication to 83 million from 72 million.
Full implementation of the new guidelines would mean 156,000 fewer deaths each year, and 340,000 fewer heart attacks, strokes and other heart-related ailments, the researchers concluded. Our study shows the benefit of risk reduction overweighs the potential risk of adverse events in the U.S. population. They highly recommend practitioners to try to adhere to the new guidelines.
Some debate has occurred since the adoption of the new guidelines regarding risks associated with blood pressure medication. Whenever there is a change in the approach to a common problem that requires an entire rethink of what has been a standard of care, there's going to be some argument, some pushback, some hesitancy.
But the new study reveals that the potential benefits of the new guidelines far outweigh the risks, he added. The researchers reported that doctors need to treat 70 people to prevent one case of heart attack or stroke, and 129 people to prevent one death.
By comparison, treatment numbers that would increase side effects associated with blood pressure medication are much higher:
1. 468 people would need to be treated to cause one case of kidney injury.
2. 603 treated to cause one case of dangerously low blood pressure.
3. 1,171 treated to cause one person to pass out from a fall in blood pressure.
4. 1,189 treated to cause one case of abnormal electrolyte levels in the blood.
The number needed to harm is hundreds or thousands, but the number needed to benefit is not only less than 100, but it's exactly in keeping with the threshold set for statin therapy for primary prevention. They have already decided when the number needed to treat to improve outcomes is less than 100, that qualifies an important public health imperative.
The author noted that 9% of people now considered to have high blood pressure would not be recommended for medication. Instead, they would try to lower their blood pressure through exercise, diet, and other lifestyle changes.
Under the new guidelines, everyone with stage 1 high blood pressure should be evaluated for heart disease. Only those with heart disease or at high risk for developing it during the next decade would be prescribed drugs.
The majority of people who are newly diagnosed ought to be able to be managed with non-drug regimens. They should not dismiss those approaches. There is a substantial benefit to be had by appropriately deploying these lifestyle and dietary changes.
They should embrace the new guideline since many more lives would be saved. The data reflect one big step toward better implementation and better outcomes.