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Blood Pressure: How Low Should You Go?

Blood Pressure: How Low Should You Go?

(Copyright DPC)

By    |   Monday, 29 August 2016 02:56 PM

If you’re one of the more than 58 million Americans who are receiving treatment for high blood pressure, you’ve probably wondered how low you need to go.

Over the years, the optimal readings have changed and they have often varied greatly from expert to expert.

But recently, a growing consensus suggest that blood pressure readings may not have to be as low as previously thought. This means you may be able to take a lower dose of your medication or you may not need any medication at all.

An increasing number of experts believe that 150/90 or lower for most people age 60 or older is acceptable. For those with diabetes or chronic kidney disease, a maximum of 140/90 is recommended.

Until recently, most experts believed that everyone should be treated when their blood pressure hits 140/90, and that people with diabetes or chronic kidney disease should be treated when their level hits 130/90.

After being on the fringes, the lower numbers have gradually infiltrated mainstream. They’ve been recommended by a panel of experts appointed by the National Heart, Lung, and Blood Institute and by doctors consulted by Consumer Reports.

Proponents of the new guidelines believe it’s unnecessary to push down blood pressure toward the optimal level of 120/80 to prevent heart attacks and strokes.

They argue that such an approach often requires high doses of multiple drugs, which increases the risk of side effects such as a nagging cough, frequent urination, dizziness, falls, and erectile dysfunction.

A major NHLBI study is underway that may settle the argument for good, but the results won’t be known until 2017.


“No one likes to take medications that they don’t need to take,” Dr. Lawrence Fine of the NHLBI tells Newsmax Health.

“Individual physicians and patients need to understand there’s uncertainty. Given that and given their own preferences and views, they need to make a (treatment) decision that they’re comfortable with.”

Fortunately, there is no disagreement about what you should do when you’re first diagnosed with high blood pressure.

The first step is to confirm the diagnosis with multiple blood-pressure readings.

“Blood pressure fluctuates from day to day and at different times of day,” says Fine. “The more readings you have, the better the estimate of your blood pressure. It’s not unreasonable to get a good home monitor and take your blood pressure at home.”

If it seems difficult to get a fix on readings, it may be worth wearing an ambulatory monitor for a few days that takes readings throughout the day and night.

The second step is to make lifestyle changes. Proven strategies include:


The low-fat DASH diet, which may reduce systolic blood pressure by 8–14 mmHg.
Regular aerobic exercise. At least 30 minutes per day most days of the week may reduce systolic blood pressure by 4-9 mmHg.
Losing weight. For every 11 pounds lost, systolic blood pressure may decline by 2.5–10 mmHg.
Reducing salt to no more than 2,300 milligrams per day, which may reduce systolic blood pressure by 2–8 mmHg.
Natural remedies. Beet juice and fruits and vegetables high in potassium (bananas, potatoes) have been shown to lower blood pressure. The supplement coenzyme Q10 also works for many people and has shown effectiveness in studies.

If your blood pressure is still elevated after six months, the third step is to choose wisely from the four basic classes of medication:


• Thiazide diuretics.
• ACE inhibitors.
• ARBs (angiotensin receptor blockers).
• Calcium channel blockers.

Your health status — as well as your race and ethnicity — will help your doctor decide which medication is best for you.
 

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If you're one of the more than 58 million Americans who are receiving treatment for high blood pressure, you've probably wondered how low you need to go. Over the years, the optimal readings have changed and they have often varied greatly from expert to expert.But recently,...
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2016-56-29
Monday, 29 August 2016 02:56 PM
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