A panel of experts chosen for the Eighth Joint National Committee (JNC 8) has raised the blood pressure rate cutoff for determining whether patients needs drug therapy for hypertension. The new cutoff for most hypertensive patients over 60 recommends that drug therapy treatment begin when systolic pressure is above 150 mm Hg or higher or when diastolic pressure is 90 mm Hg or higher, while for younger patients or anyone with diabetes or chronic kidney disease, treatment is now recommended when systolic pressure is 140 or higher or diastolic pressure is 90 or higher.
The new cutoff primarily affects the treatment of hypertension in older patients, by recognizing that there is a natural tendency for the average blood pressure to raise with advancing age. Previous guidelines failed to give this distinction enough weight, while the new guidelines allow for more personalization of treatment recommendations. The new guidelines also emphasize lifestyle changes to be implemented before resorting to drug therapy.
“For all persons with hypertension, the potential benefits of a healthy diet, weight control, and regular exercise cannot be overemphasized. These lifestyle treatments have the potential to improve blood pressure control and even reduce medication needs,” wrote the panel.
Hypertension can have a variety of harmful effects including enlarged left heart, coronary artery disease, heart failure, artery damage, scarring and failure of the kidney, kidney artery aneurysm, mild cognitive impairment, brain aneurysm, ministrokes, strokes, and even dementia. Drug treatment for hypertension can also have negative side effects, however, including increased urination, erectile dysfunction, gout symptoms, asthma symptoms, depression, insomnia, chronic coughing, skin rash, dizziness, anemia, and other effects depending on the type of treatment and response of the individual patient.
In addition to lifestyle changes like better nutrition, exercise, and stress management habits, Chiropractic Adjustment and Professional Massage Therapy can prove beneficial to many patients in preventing or helping to reduce or eliminate hypertension. Hypertension can affect people of every age, and especially those with medical complications such as kidney disease and diabetes. In over thirty years of practice I have treated many patients for hypertension and helped them avoid the dangerous side effects that can sometimes accompany drug therapy, which as these new recommendations reveal is often an unnecessary risk.
Dr. Michael Petrie, D.C.
Spine and Joint Center