New Hypertension Guidelines, Are They For Real?

Hey, everyone. All right, so today, different article to talk about. I'm going to spend some time talking about the article and then some time talking a little bit about just, generally, what it means to you and what it means in clinical practice. That'll make more sense to you in a minute. The new article is ... This comes from CNN, not always who I go to for medical information, but you'll see why I did in this case. The article title is Nearly Half of Americans Now Have High Blood Pressure Based on New Guidelines. Let's see who it is ... according to American Heart Association, American College of Cardiology, and they say, nine other health professional organizations. They've come out with new guidelines for blood pressure.

                                           It used to be that anything, blood pressure wise, 140/90 they started to pay attention to. That was kind of entry-level high blood pressure or hypertension. Now they're saying 130/80 gets you into the diagnosis of high blood pressure and that they're going to have to start treating it at 130/80. Interestingly enough, that means that about 50% of all men and 38% of all women, adults, in the US will now be considered to have high blood pressure. I think the numbers come out that that's ... That takes us from about 72 million Americans to just over 100 million Americans with high blood pressure now.

                                           What they're saying in these guidelines ... and it's, apparently, a very large document. I pulled it up online, scrolled through some of it, and it's a huge volume of a document that, probably, very few people are going to read. I chose not to. It says that the guidelines state that, in that 130/80 range, patients will not generally be given medication. They will be counseled on lifestyle and diet changes and those kinds of things. I kind of take issue with that because when I hear patients come in that have been counseled on lifestyle and diet changes, the changes they've been counseled to make are usually not productive changes when it comes to things like blood pressure.

                                           For example, they're continuing to keep watching your salt intake on the list. I'll talk about that in minute. They're going to ... whatever dietary change. I don't know if they're going to go low-fat or whatever. They're very vague about that. But then you know what's going to happen is doctors are busy. They assume patients aren't going to make changes, and the next thing you know, you have another 30 million people being put on blood pressure medication. It's interesting, as we all know, you change the parameters a little bit, and now you've got 30 million more people that qualify to be on your medication. Insurance companies will have to absorb the cost of that, as will some patients, and then you'll have that many more people taking drugs. Then they're going to need something for the side effects of those, and so on and so forth. I don't think it's a great situation, but that's the situation we're in now.

                                           They still say, and this is worth you knowing, that a hypertensive crisis, that's when your blood pressure is high enough that, you know what? I think I'm just going to go to the emergency room and find out what's going on, that's still if the top number is above 180 or if the bottom number is above 120. Either one of those should send you to the emergency room to have your blood pressure checked. I'm not telling you that all blood pressure cases are just BS, but I think this new lower standard is ... I don't know. I don't think it's based in the right kind of science.

                                           They admit in the CNN article they interviewed a couple of doctors, and one of the ones was honest and said, "Look, we can see people," he gave examples, "that have a blood pressure like 166/80 in the office, but when we send them home and they monitor it daily on their own for a while, they're averaging 128/70." They don't like being in the doctor's office. They don't like waiting in the waiting room. They don't like going through traffic. They don't like arguing with the doctor and knowing they're going to get prescribed something they don't want to take. Whatever the case is, they're not happy about being there, and so the blood pressure goes up. They are aware that you can't just medicate someone based on a single reading like that.

                                           Let's talk about some of the issues I have with this. First of all, with blood pressure, blood pressure's a very complicated issue to deal with, right? If a patient comes into a doctor's office with high blood pressure, the general standard now is just treat it, just get rid of the high blood pressure. Put them on a medication, drop the blood pressure, and don't ever ask why it got high in the first place. That has problems. Sometimes your blood pressure goes up for a reason. Sometimes your blood pressure gets high because there was a partial blockage somewhere and your body couldn't get blood to where it needed to get to.

                                           Let's say there's a blockage in one of the arteries to the kidney, and the vascular system gets a feedback mechanism, a message sent to it that says, "Hey, I'm not getting enough blood over here. Raise the blood pressure and get me more blood," so it raises the blood pressure. Well, you go to the doctor for that, and what they end up doing is they just give you medication that drops the blood pressure. Now your kidney's starving. Nobody looks for why your blood pressure got high. That's a problem. It's so easy for them to just give medication and lower it, they never look for why it got high. They don't ask.

                                           When you talk to neurologists, there is a growing concern in neurology that one of the reasons we're seeing so much more dementia and Alzheimer's and the kind of neurodegenerative issues we talked about on yesterday's video is because we're lowering the blood pressure to the point where people are not getting enough blood to the brain, and the brain starts to starve. It's not that different than the kind of brain degeneration when you have recurrent sleep apnea. You keep starving yourself of oxygen throughout the night, and it's like having little strokes in the brain because it gets deprived of oxygen. Well, if you drop the blood pressure too low with a medication or you drop it low enough that they can't profuse their brain, you're accomplishing the same thing. The blood pressure looks good. The cardiologist did his job, but now the poor neurologist has a starving brain on his or her hands that they're trying to fix or get to survive, so you do run into some issues with this.

                                           Likewise, like they mentioned, if you get a patient in the doctor's office whose blood pressure is at a treatable level, but at home on a daily basis maybe it's not, if you put that person on blood pressure medication, you've now grossly over-treated them, right? You've dropped their blood pressure way too low, so now their risk of getting dizzy when they stand up, and falling, breaking a hip, whatever, that increases significantly.

                                           Lowering the standards for blood pressure or for high blood pressure can be marketed as we really want to make sure we're treating everybody that has the issue. We don't want anybody to slip through the cracks. We're narrowing it down. We're being pickier, and we're going to be more aggressive about treating this to get this problem under control. That sounds great until you consider the fact that we may end up treating millions of people that really don't need it. We may cause more problems than we get rid of in a lot of these people, and we still don't know why they have high blood pressure, and we're just going to be selling them a bunch more medication.

                                           That's not the way they're going to present it, right? When the press releases come out, it's not going to be that. It wasn't that in the CNN article. I wanted to bring that up, and I wanted to mentioned it. I also wanted to go through the fact that blood pressure should be something that's investigated with the purpose of finding out why you have high blood pressure in the first place. That's not easy to do, but that should be the goal.

                                           I want to talk about salt for a second. I mentioned it. I said I'd come back to it. In my opinion, there are two different types of salt that we come into contact with. There is industrial salt and nutritional salt. Industrial salt is the salt that's in our processed foods, anything from just plain old table salt all the way up to MSG, monosodium glutamate, things like that, real chemical salts. They're used for different reasons. Food scientists like them because they make the food so much more palatable. They can almost make it addictive. They hit certain receptors in the brain that cause excitation in there, and so they love them from that perspective. The food industry likes them, but they're not nutritive for us. They don't provide the minerals that our body would normally expect to have come in with salt.

                                           Things like the pink Himalayan salt or I think Redmond is a company that makes a product called Real Salt. I would call it dirty salt. It's salt that comes with lots of other minerals. If you took clean ocean water and just dehydrated it, you're not just going to get sodium chloride. You're going to get lots of other minerals and trace minerals in there. That's the kind of salt our bodies are looking for. There are doctors that really believe and theorize that, and I think, to some degree, have some good proof that if you're deficient in real salt, you become very overreactive to commercial salt or industrial salt, and that when you're one of those people that you take in salt and, all of a sudden, your fluid levels are all over the place, your blood pressure goes up, or you get vertigo, or your ankles swell, or whatever, it may be because you're taking in the wrong kind of salt.

                                           I don't have the book here. It's at home. I'll try to remember to put a citation for it in the notes. There's a really good book out about our relationship with salt, the different kinds of salt, how to consume salt properly, when to know that salt's a problem for you, that kind of stuff. I'll try to come back afterwards and put the reference to that. I can picture it. It's a light blue book with a salt shaker on the front of it. There are good kinds of salt. Salt is not always evil, and there's good research now that says that even avoiding the bad salt generally doesn't have much of an effect on lowering your blood pressure, so for whatever that's worth.

                                           Anyway, that's what I wanted to talk about today. The CNN article, I should give you ... Sorry, I should give you the details on it. It was by Susan Scutti, S-C-U-T-T-I, and it was published November 4, 2017, so fairly recent. Anyway, wanted to give you that reference so you can find it. I usually, when I post this, try to put the reference in there. If you have any questions, type them in below, any comments, feel free to share it. If you go to your doctor anytime soon, you will likely be diagnosed with high blood pressure, 50/50 chance, almost, that you'll be diagnosed with high blood pressure and counseled on your diet and lifestyle. Anyway, get in touch with me if you have questions, and until next time, eat for your health, train for performance, and live the life you love today. Have a good one.