This is the time of year when long summer days and vacations are only memories. Work and school schedules seem to stretch from dawn to dusk. And holiday planning is looming. For those still on the farm, the harvest has to be brought in and the fields and livestock need to be readied for winter.
All of this can add stress to your life. And, as you know, stress is the silent killer when it comes to cardiovascular diseases, metabolic diseases, and other chronic illnesses—in part because it can cause your blood pressure to spike.
But it turs out that not all boosts in blood pressure are bad for you. In fact, surprising new research indicates that moderate increases in blood pressure as you get older may actually be good for your health.
That’s right: New studies show that blood pressure levels that are slightly higher than the currently accepted “gold standard” of 120/80 may not harm your cardiovascular or cognitive health.
The research is so compelling that a government committee of medical experts recently increased the “safe” blood pressure levels for people over age 60. The committee recommended that treatments to reduce blood pressure for this age group not begin until BP levels are over 150/90.1
Other medical professionals are a bit more conservative. As I reported in my Daily Dispatch e-letter back in July, recent discussions in both the British Medical Journal and the Journal of the American Medical Association recommended raising the level at which drug treatment should begin. (The BMJ article suggested 160/100 as the threshold, and JAMA suggested 140/90).
So how did these eyebrow-raising developments come about? After all, for decades, the most common blood pressure adage has been “the lower, the better.” And as I’ve often noted, managing blood pressure is the single most important step you can take to reduce your risk of cardiovascular disease (see sidebar).
But the practice of medicine is both an art and a science, and it is continually evolving. New, expanding research on different age groups of adults is revealing that my frequent admonition—“moderation in all things”—also appears to be applicable to the concept of healthy blood pressure.
One thought is that blood pressures slightly above “normal” may actually assist older people in maintaining adequate blood circulation to the heart muscle and brain—thus helping to stave off heart attacks and strokes. And slightly higher blood pressure may also help pump more oxygen and glucose to sensitive tissues like the brain, preserving memory and cognition.
Let’s take a closer look at this new research, along with steps you can take to manage your blood pressure in light of these new findings.
Moderately high blood pressure may not lead to heart attacks or strokes
A blood pressure reading between 120/80 and 140/90 is considered mild, or early, hypertension. Traditionally, many doctors prescribe blood-pressure lowering drugs to people in this range.
But new research is showing that this practice may actually be dangerous for your health.
Although earlier studies indicated that the risk of heart disease progressively increases as blood pressure rises above 115/75, a June 2014 study showed that lowering systolic blood pressure below 120 in adults with hypertension did not reduce the rate of heart disease or stroke.2
In this study, 4,480 people were followed for 21 years. At the start of the study, nearly three-quarters of the participants were taking a blood pressure drug, almost one-fifth had diabetes, two-thirds smoked or drank alcohol, and about one-quarter had “high” cholesterol (as defined at that time).
At the end of the study, the researchers found that people whose blood pressure was lowered to a level below 120 didn’t have any less risk of cardiovascular disease than the people who remained at the 120 to 139 level.
What’s more, the researchers concluded that using drugs to reduce blood pressure below 120 may lead to dizziness, fainting, and other side effects—which can actually increase health care problems and costs over the long run.
An even more recent study found that overly aggressive lowering of blood pressure actually made people’s health worse.3
This study reviewed data on 398,419 people taking blood pressure medications for three to five years. The researchers found that lowering blood pressure below standard levels resulted in greater risk of end-stage kidney disease, kidney failure, and even death.
The lowest risk was associated with a blood pressure reading of precisely 137/71. In people with diabetes (who are at greater risk for kidney disease), the lowest risk was at 131/69. For people age 70 or older, the ideal level was 140/70.
Of course, today’s new drugs for treating blood pressure may be riskier than staying with the old generic standbys that have already been proven effective over decades for millions of people. My colleague Donald Light, MD, recently published a review of all of the drugs approved by the FDA in the past 30 years. He found that only 10 percent of the new drugs were more effective than the old drugs they were meant to replace. But fully 50 percent of the new drugs were less safe than their older counterparts.4
In light of this evidence, I bet that researchers would find that treating blood pressure under 140/90 is less risky if doctors considered using only the older, safer drugs. Unfortunately, that’s not likely to happen anytime soon.
Taking pressure off the brain
Of course, blood pressure doesn’t just affect the heart. It’s also a key component in brain function, including cognitive decline.
Thirty years ago, doctors like me were taught that a “normal” systolic blood pressure was 100 plus your age. So an 80-year-old with blood pressure of 180 was nothing to worry about. Over the years, that thinking changed, and doctors began using more drugs in more patients with elevated blood pressure levels. But interestingly, new research is showing that—at least in relation to the brain—my early medical school teachings may have been right all along.
In an August Daily Dispatch, I reported a surprising finding that people who first developed high blood pressure in their 80s or 90s actually had a lower risk of dementia.5
And a recent study from Johns Hopkins University found that people who developed hypertension only after age 68 didn’t have any more cognitive decline than people with normal blood pressure. 6
But there is a caveat: The researchers also found that high blood pressure during middle-agewas linked to steeper cognitive decline as they grew older.
Lower your blood pressure without drugs
The good news in all of these recent findings is that it looks like we can afford to begin relaxing blood pressure control somewhat—especially as we grow older. And once again we can look to the golden rule of moderation as our guide.
But if you do have blood pressure above the now-recommended treatment levels of 140/90 or 150/90, you should check with your doctor about starting a treatment program (just be sure to insist on older, proven, safer drug treatments).
But there are also non-drug treatments that can help you manage your blood pressure. In fact, there are many proven, effective, and widely available mind-body techniques that can help reduce blood pressure. To find out which ones will work best for you, take the short Emotional Type Quiz at www.drmicozzi.com or read my book, Your Emotional Type: Finding the Treatments That Will Work for You.
And as always, good cellular hydration and nutrition are also keys. For more specific advice, you can refer back to my report The Insider’s Secret to Conquering High Blood Pressure & Protecting Your Heart which you received with your subscription to Insiders’ Cures.*
One final note of caution: If you monitor your BP at home and find a reading over 180/110, check it again. If it persists, you should seek urgent care to lower it. And be sure to check both arms!
The “Goldilocks principle” of blood pressure balance
As I’ve said many times before, high blood pressure is the single-most important risk factor for heart disease.
Higher pressure in the arteries places more stress and wear and tear on the linings of the blood vessels, which contributes to the development of atherosclerotic arterial disease. And atherosclerotic arterial disease is the cause of heart disease, stroke, and peripheral vascular disease. This factor is particularly apparent when blood pressure hits 180 or higher—a level where treatment is mandated, and may even represent a medical emergency.
Of course, on the other end of the scale, low blood pressure can also pose serious risks, including weakness, dizziness, and fainting. Extremely low blood pressure can deprive your organs of oxygen-rich blood, which can lead to heart, kidney and/or brain damage
So it is important to keep your blood pressure “just right.” High enough to maintain adequate blood pressure in order to provide enough blood, oxygen, and glucose to the brain, heart, and other organs. But low enough to keep arteries and blood vessels smooth—and stop cardiovascular diseases from taking hold.
1James PA, et al. 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults. Report From the Panel Members Appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014;311(5):507-520. doi: 10.1001/jama. 2013.284427.
2Rodriguez C, et al. Waste and Harm in the Treatment of Hypertension. Journal of the American Medical Association Internal Medicine June 10, 2013; 173(11): 956-957.
3Sim JJ, et al. Impact of Achieved Blood Pressures on Mortality Risk and End-Stage Renal Disease Among a Large, Diverse Hypertension Population. J Am Coll Cardiol 2014; 64(6), 588-597.
4Risky Drugs: Why the FDA Cannot be Trusted. http://www.bibliotecapleyades.net/ciencia/ciencia_industryweapons295.htm. Accessed August 21, 2014.
5Alzheimer’s Association International Conference (AAIC) 2014. Abstract P2-083. Presented July 14, 2014.
6Gottesman RF, et al. Midlife Hypertension and 20-Year Cognitive Change: The Atherosclerosis Risk in Communities Neurocognitive Study. JAMA Neurol. 2014 Aug 4. doi: 10.1001/jamaneurol.2014.1646.