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Gingersnap
03-10-2011, 03:10 PM
New York / Heidelberg, 9 March 2011
Redefining normal blood pressure

Current US definition of 'normal' blood pressure may unnecessarily label 100 million Americans as 'abnormal'


As many as 100 million Americans may currently be misclassified as having abnormal blood pressure, according to Dr. Brent Taylor from the Veterans Affairs Health Care System in Minneapolis and the University of Minnesota and his colleagues. Their findings (1) show that these people are not actually more likely to die prematurely than those with 'normal' blood pressure, i.e. below 120/80. Taylor and colleagues’ article in the Journal of General Internal Medicine (2), published by Springer, also shows that in those under 50, diastolic blood pressure* is the more important predictor of mortality, whereas in those over 50, systolic blood pressure* is the stronger predictor. The authors argue it is time to consider a new definition of 'normal' blood pressure.

Taylor and colleagues examined the independent contribution of diastolic blood pressure (DBP) and systolic blood pressure (SBP) on mortality, as well as how these relationships might affect the number of Americans currently labelled as having abnormal blood pressure.

The authors looked at data for 13,792 people from the National Health and Nutrition Examination Survey, which enrolled participants in 1971-76 and followed them up for two decades – they studied DBP, SBP and long-term survival data specifically. In order to assess the underlying distribution of untreated blood pressure in American adults by age, Taylor and team also looked at data for 6,672 adults from the first National Health Examination Survey carried out between 1959 and 1962.

They found that in people aged over 50, those with SBPs above 140, independent of DBP, were significantly more likely to die prematurely. In those aged 50 or less, DBPs above 100 were linked to significant increases in premature death. The authors' analysis offers alternative cut-off points for the definition of 'normal'.

Dr. Taylor concludes: "Our findings highlight that the choice of approach used to define normal blood pressure will impact literally millions of Americans. If we cannot reliably see an effect on mortality in a large group of individuals followed for nearly 20 years, should we define the condition as abnormal? We believe considering this kind of approach represents a critical step in ensuring that diagnoses are given only to those with a meaningful elevation in risk, and targeted towards individuals most likely to benefit."

Interesting.

Springer (http://www.springer.com/about+springer/media/springer+select?SGWID=0-11001-6-1108922-0)

noonwitch
03-10-2011, 03:13 PM
My grandpa is 98 and has had high blood pressure since he was in his 60s. He did have a stroke, but it was a post-operative complication that is common in men who undergo prostate surgery. Plus, he's lived 14 quality years since that stroke.

My mom has high blood pressure that started during menopause. She takes medicine for it and has no serious health problems, outside of mental health issues. She's 71.

My pressure is usually about 120/85. I think that's pretty good for a smoker in her mid 40s.

MrsSmith
03-10-2011, 06:19 PM
My blood pressure was always under 120/80...usually closer to 110/75, unless I happened to be very angry. Since I work on medical equipment, I take my blood pressure all the time when checking machines.

I noticed a huge difference as soon as I entered menopause. Suddenly, my pressures were all over the place. I eventually figured out that the days I was bloated were the days my pressure was high.

Obviously, my arteries didn't all clog up instantly, so I think people need to be aware that there are a lot of other reasons for high readings.

In fact, since I work on these machines, I've often fudged the reading by as much as 20 mmHg by holding my arm in different positions, moving it, or tensing the muscles.

Gingersnap
03-10-2011, 10:32 PM
My grandmother always had erratic blood pressure and she had to sit in the doctor's office and had it taken 2 or 3 times.

I'm in the same boat. I hate the whitecoats so much that my BP goes skyhigh and then drifts down to normal or a little below normal after several attempts. My Doc is well aware of this so the multiple readings are just routine for me. Since my "real" BP is always fine, there's been no suggestion of medication.

This BP story points out the dangers of over-relying on clinical "goals". Your BP, total cholesterol, or whatever may not indicate as much as the number-crunchers would like. Targets have been dropping for all standard tests over the past 15 years with no real gain.

In addition, there is a belief that artificially replicating readings for the average 25 year old in the average 50 year old have big benefits. This may not be true at all. We are designed to age. In the end, no matter how well you have managed your health, you will die from cancer, cardiovascular disease, or infection. The difference, if any, is when. ;)

djones520
03-10-2011, 10:35 PM
I'm always told I have good BP, which is always a bit of a relief for me, since heart disease and high blood pressure is a problem in our family.

Though the machine at our gym keeps telling me I'm about to have a stroke. :rolleyes:

CaughtintheMiddle1990
03-11-2011, 06:16 AM
My blood pressure was always under 120/80...usually closer to 110/75, unless I happened to be very angry. Since I work on medical equipment, I take my blood pressure all the time when checking machines.

I noticed a huge difference as soon as I entered menopause. Suddenly, my pressures were all over the place. I eventually figured out that the days I was bloated were the days my pressure was high.

Obviously, my arteries didn't all clog up instantly, so I think people need to be aware that there are a lot of other reasons for high readings.

In fact, since I work on these machines, I've often fudged the reading by as much as 20 mmHg by holding my arm in different positions, moving it, or tensing the muscles.

This is my range too.
However, I have had times where it was 130/77 or the like. One time when taking two medications a little two close together it dropped to 80/50.

My grandpa suffered from hypertension and had two strokes--one moderate but not at all disabiling, the other fatal two years after the first. His B/P was in the 130/80 to 140/80 range, at least in the year after his stroke--He was in the hospital for a minor chest infection and the medical report states that on admission (while on Aldomet, his anti-hypertension med) it was 130/80, and that at times during his two week stay at times it was stable around 140/80.

FDR, in his last year of his presidency, had blood pressure which was incredibly high yet he still managed to do his job. Around DD, it was 226/118. By Yalta, it was 250/150. Neither digitalis nor other available medication seemed to have any effect on it. On the morning he died, it was reported oddly low (for him) at 150/80. However, a B/P rating taken within minutes of his fatal stroke that afternoon revealed a B/P of 300/190

noonwitch
03-11-2011, 09:02 AM
I'm always told I have good BP, which is always a bit of a relief for me, since heart disease and high blood pressure is a problem in our family.

Though the machine at our gym keeps telling me I'm about to have a stroke. :rolleyes:

Sometimes, the machines they use at the gym are also the kind that are sensitive to noise.