When You Should Use Drugs to Treat High Blood Pressure

Researchers have shown in past studies that multivitamins can greatly reduce your risk of high blood pressure. And, in past issues, Ive told you about nutritional supplements you can use instead of drugs to treat high blood pressure. There are times, though, when drugs are necessary. But you have to know when to use them and which ones to use.

Obviously, prevention is best. Unfortunately, most people just ignore the disease and do not know if they have it. Its a silent disease. If not checked, you might not know until damage has already been done. Research shows that 73 million Americans have hypertension, and many do not even know it. Do you?

Dr. Christopher Granger is a Duke University cardiologist. He and colleagues at nearly two dozen U.S. institutions set out to find out what happens to patients with severe hypertension when they come to an emergency room. By severe, their blood pressure had to be above 160/110.

If their blood pressure was that high, 90% of them already had a diagnosis from their doctor. About 25% of them were not taking the drugs their doctor prescribed.

The researchers also found that extremely high blood pressure was related to high rates of complications and death rates. Many of the patients already had major organ damage and over 6% of them died in the hospital.

Upon discharge, attending doctors gave most of the patients prescriptions for at least two medicines. But 41% had to be readmitted within three months. What may be most unsettling, however, is what the investigators could not find in the discharge records. About 60% of the charts did not show any attempt by the patient or their doctor to schedule a follow-up appointment.

Dr. Solomon Aronson is an anesthesiologist also at Duke. He sees danger in high blood pressure from another angle. He has spent years trying to discover the sweet spot, or ideal range, of blood pressure during cardiac surgeries. Aronson led a team of investigators that analyzed over three million blood pressure readings in the records of 5,238 cardiac surgical patients at Duke over a nine-year period. They found that when the systolic blood pressure was below 95 or went higher than 135, the patients had a greater risk of death within the following month. The risk of death increased the greater and longer deviation from that range.

I am a little tighter in guidelines. Ive seen research that your risk of vascular disease increases with systolic blood pressure over 120. That means that the long-held normal level of 120/80 is really the upper end of the safe zone. I believe normal blood pressure should be closer to 110/70. Mine ranges from 95-115/65-75.

I am refreshing your memory on hypertension because it affects one out of five Americans. You might not know that you have it. The causes are not a deficiency of drugs. The causes range from heavy metal poisoning to nutritional deficiencies, to sleep apnea, stress, and poor lifestyle. Even a lack of sunlight and a vitamin D deficiency could cause it!

That said, I am not against the judicious use of drugs to treat hypertension — especially if you have made good lifestyle changes and are otherwise dependent on third-party payment. Third parties, including Medicare, are resistant to natural treatment, even if they are less costly than chemicals. If your BP it greater than 160, the risks of the disease outweigh the risks of drug treatment.

I do suggest re-reading my past suggestions for no-drug management of your blood pressure. However, I would far rather you take a drug for hypertension than let it go untreated, especially for systolic BP over 160. If you choose drugs, I suggest starting with a thiazide diuretic and supplement with potassium (99 mg one to two times daily) and magnesium (250-500 mg two times daily). If that does not help, my next choice of drugs is one from the ACE inhibitor class.

Ref: ScienceDaily, February 3, 2008.