And why you’ll be safer ignoring the new guidelines
While everyone was getting ready for the holidays, suddenly there were screaming headlines proclaiming, that “millions” more Americans will need blood pressure treatment.
The message was that blood pressure readings which had previously been considered safe—and essentially healthy—are now suddenly too high.
In fact, two large medical organizations I call the “delusional duo” have decreed that the new “normal” level should be less than 120/80. And “high” blood pressure starts at a reading of 130/80.
This means that a whopping 46%, or 103 million, American adults are now defined as having high blood pressure. And among people under age 45, the rate has doubled for women and tripled for men.1
The suspicious data behind the new guidelines
Since blood pressure is a serious risk factor for heart disease, we need to consider this new proclamation very seriously. Particularly because it flies in the face of real evidence I’ve long reported about healthy blood pressure levels—and how those benchmarks change as we age.
So I looked past the headlines—something many doctors don’t do.
I found that this “new” evidence about healthy blood pressure readings came primarily from a clinical trial where researchers jumped to conclusions so fast, the study was never even completed. Plus, the researchers rushed to publicize the “results” in the media even before this incomplete study was published in a medical journal!
But the biggest mystery of all is that this faulty study was published two years ago—so why has it suddenly resurfaced? And why have the “delusional duo” of the American Heart Association (AHA) and American College of Cardiology (ACC) decided to issue new blood pressure recommendations now, based on this highly questionable study?
Today I’ll reveal what you really need to know about high blood pressure. I’ll also share my all-natural prescription for lowering blood pressure—and preventing heart disease—without drugs.
The lower the blood pressure, the more prescriptions written
In recent years, doctors were told to aim for a systolic blood pressure of less than 140 mm Hg for all adults, based on evidence from studies. Then in 2013, recommendations were relaxed to less than 150 mm Hg for people age 60 and older—again, based on evidence. In March 2017, the American College of Physicians and the American Academy of Family Physicians published clinical guidelines based on the 2013 recommendations.2
Why? Because as you get older, slightly higher blood pressure levels help support healthy circulation of blood and oxygen to the brain, heart, and other tissues—helping prevent cardiovascular disease and dementia. Higher levels also mean fewer blood pressure drugs are needed.
But because the AHA and ACC apparently couldn’t leave “well enough” alone, the guidelines they released in November 2017 mean doctors will need to write millions more prescriptions to lower blood pressure even further than what has long been considered normal. This means not only more drugs for more people, but more drugs being taken by the same people.
In fact, to reduce blood pressure to the new, lower levels, patients in the study I mentioned above ended up taking three drugs on average, or more. As I report on page 6, this type of multiple drug use can cause deadly side effects and interactions.
Are we heading for yet another big pharma boondoggle?
Unfortunately, there’s no real evidence for this “new” proclamation about reducing blood pressure. In fact, it reminds me of all of the hoopla a couple decades ago about how lowering blood cholesterol would lower the risk of heart disease.
This “coincidentally” occurred just after statin drugs hit the market. Thanks to the “cholesterol boondoggle,” big pharma was able to sell billions of new pills, for billions in profits, to millions of new patients who were perfectly healthy—but only at presumed risk of heart disease.
Unfortunately, it turns out these cholesterol “wonder” pills eventually led to more problems than they could ever hope to solve—including cases of cataracts, dementia, diabetes, kidney disease, muscle problems, and even heart disease itself.
Now, the lucrative patents for statin drugs are expiring, and big pharma needs a new fix. So, suddenly we have new, lower blood pressure guidelines. Coincidence? I think not.
One faulty study led to a nationwide mess
The study the AHA and ACC based their new guidelines on is called SPRINT (Systolic Blood Pressure Intervention Trial).3 This study was designed to see if people who have a systolic blood pressure reading of 120 have less risk of heart disease, stroke, kidney disease, and memory and cognition loss compared with people with a 140 reading.
The study evaluated 9,361 men and women, age 50 or older, with a systolic blood pressure reading of 130 or higher, and at least one cardiovascular disease risk factor. The participants were divided into two groups—the intensive treatment group, which took medications to lower their BP reading to 120, and the comparison treatment group, which aimed for a reading of 140.
The study began in 2013 and was expected to last four to six years, but researchers shut it down after only two years. They attributed this to the “superior benefits of the more intensive blood pressure treatment intervention on the primary outcome and on total mortality.”4
These results were hardly “superior.” In fact, SPRINT is certainly an appropriate name for this study, considering the record-breaking speed the researchers set in jumping to these conclusions. But the sprint has now turned into a marathon, as they come around for another long lap—two years later.
The SPRINT findings were published in November 2015, but an article in the New York Times by Gina Bari Kolata (who I’ve known for many years) had already “scooped” the results two months earlier.5
I thought Gina’s story was the last we’d hear of SPRINT. But now, she (and many other journalists) are once again reporting on it, thanks to the ACC and AHA’s inexplicable resurrection of this faulty study and their subsequent new blood pressure guidelines.
The real numbers you need to know in the SPRINT study
As I mentioned above, the reason SPRINT was stopped prematurely was because the study participants in the most intensive treatment group (achieving 120 systolic blood pressure) had a lower incidence of cardiovascular complications compared to the standard treatment (140 systolic BP).
These results were heralded as earthshaking. But in reality, the intensive treatment group had a cardiovascular complication rate of 1.7% per year, while the standard treatment group had a rate of 2.2%. The actual risk reduction was just 0.5%. But because of the large number of study participants, this meager result was able to achieve statistical significance.
In other words, when the actual risk reduction is so small, the number of people who need to be treated to try to prevent just one bad outcome becomes very large. Of course, treating larger numbers of otherwise healthy people is just what big pharma wants, as we saw with cholesterol drugs.
Even the authors of the SPRINT study admitted that to prevent one death, 172 people would have to be intensively treated for three years. Meanwhile, the other 171 people would be subjected to multiple toxic, dangerous, and potentially deadly side effects from blood pressure drugs—with no benefit. A terrible model for medical practice and public health.
But that’s not all that’s wrong with the SPRINT study…
Five fundamental flaws that clouded results—and put YOU at risk
There are many reasons why this study should never have been used as the basis of new blood pressure guidelines. But here are the top five:
1.) The study was not blinded.
Instead, it was “open-label,” meaning that the people who participated in the study, along with their physicians, knew exactly what treatment group they were in and which treatment they were getting. And that means their expectations could influence the study outcome.
Blinding is done to eliminate bias and the placebo effect—a very real phenomenon in which people respond to an intervention simply because they expect that they will, regardless of whether or not it has any true therapeutic value.
There’s no physiologic measurement I can think of more subject to the placebo effect than blood pressure. It’s an exceptionally volatile biologic variable, changing constantly in response to stress, activity, environment—especially being in a doctor’s office or medical clinic.
In fact, bias and the placebo effect can account for the entire outcome of a study like this, especially when the treatment effect is small, as it was in the SPRINT study.
2.) The researchers didn’t use realistic blood pressure measurements.
Participants’ blood pressure levels were taken as an average of three measurements during an office visit, while the person was seated, and after five minutes of quiet rest. There were no staff members in the room.
All of these factors are indeed needed for an ideal measurement. But when is the last time you had your blood pressure measured that way in a busy medical office? A systolic blood pressure of 130 under the ideal circumstances of the SPRINT study probably translates to 140 or 150 in real-world circumstances.
So people who might have lower blood pressure when they’re not in a stressful situation are in danger of being prescribed unnecessary blood pressure medications, based on the fantasy-world measurements used in the SPRINT study.
3.) The study measured too many different outcomes.
Another fundamental error was using a composite endpoint. Researchers are taught to assess one outcome, or endpoint, per clinical trial. But the SPRINT researchers used a laundry list of endpoints.
In other words, instead of conducting a study to see if lowering blood pressure reduces heart disease, the SPRINT researchers evaluated blood pressure’s link to heart disease, kidney disease, stroke, and age-related declines in memory and cognition.
Composite-endpoint studies are often done to magnify the effect of a treatment (like blood pressure medication), particularly when the occurrence of individual outcomes is too low to observe anything. It’s another statistical gimmick, employed to get a “significant” result.
4.) The monitoring committee didn’t do its job.
All studies have data and safety monitoring committees. These committees confidentially monitor ongoing findings to observe whether a benefit becomes so obvious, there’s no need to continue the study. They also observe whether any dangerous side effects arise that would cause the treatment to be discontinued.
When I was at the National Institutes of Health, confidential monitoring was a major component in conducting proper studies. And it’s been a critical component of controlled, blinded clinical trials for decades.
Yet, the SPRINT study didn’t bother with blinding, so the whole concept of confidential data monitoring was irrelevant—since everybody knew everything all along.
Nonetheless, the SPRINT data and safety monitoring committee stopped the study years ahead of schedule— when the intensive treatment group was observed to achieve only a slight reduction in composite outcome (but only using the statistical gimmicks I already explained).
So you have to wonder what the real purpose of this otherwise useless committee really was?
Well, one thing that ending the study early did achieve was to downplay the dangerous side effects of the blood pressure medications the researchers used. These side effects would have typically increased over time if the study had been allowed to continue as originally designed and intended.
In fact, serious side effects had already been observed in the intensive treatment group when the study shut down.
We’re talking about dangerously low blood pressure (hypotension) and fainting (resulting in bone fractures), along with potentially fatal electrolyte disturbances. Furthermore, the risk of acute kidney failure was twice as high in the intensive treatment group.
5.) People with diabetes were excluded from the study.
Of course, many people with high blood pressure also have diabetes, and there have been multiple studies on both conditions. One of the most significant is ACCORD (Action to Control Cardiovascular Risk in Diabetes).
This study of over 10,000 people found that not only was there no benefit to intensive blood pressure and blood sugar treatments, but lowering blood pressure and blood sugar too much was actually associated with higher mortality.6
But by refusing to include people with diabetes in their study, the SPRINT researchers made sure the ACCORD findings, from a real scientific study, didn’t interfere with their rush to judgment.
And ironically, the new blood pressure standards that are based on the incomplete SPRINT “results” are meant to apply specifically to people with diabetes—and especially younger people.
So what can you do to avoid the pitfalls of the SPRINT trial?
The safest ways to manage your blood pressure
My advice is to stay with the sensible guidelines of 140 or 150 systolic blood pressure levels, especially if you are over 60. To achieve this goal, I recommend the following:
Manage stress and practice relaxation by using mind-body techniques. You can discover which ones that will work best for you by taking my short quiz, “Find your boundary type” found on my website, www.DrMicozzi.com.
Get regular, moderate exercise, preferably outdoors in sunshine and nature (see page 5 for specific recommendations).
Follow a healthy, balanced diet, including plenty of fruits and vegetables. Fruits are fine, even if you have diabetes. Fructose (the natural sugar found in fruit) appears to bypass the body’s insulin responses associated with metabolic syndrome and Type II diabetes. In fact, compared to sucrose (table sugar) and glucose (natural corn syrup), it invokes a much lower insulin response.
Supplement with vitamins B, C, and D. Each of these powerhouse nutrients have been shown in studies to lower or maintain a healthy blood pressure. I recommend a high-quality B vitamin complex daily, along with 10,000 IU of vitamin D. And take 250 mg of vitamin C twice a day.
Don’t forget the fish oil. Research shows fish oil can lower blood pressure in people with hypertension. I recommend 1 to 2 grams of DHA/EPA fish oil a day.
Take magnesium. In the October 2016 issue of Insiders’ Cures (“The critical mineral that could save you from diabetes, depression, migraines—and more”), I discussed a review of 34 clinical trials (all double-blind, unlike the SPRINT study) showing that magnesium can lower blood pressure as well as drugs. I recommend 400 mg daily.
Embrace herbal medicine. In a September 2017 Daily Dispatch (“Six herbs for high blood pressure management”) I wrote how hawthorn, coleus, lily of the valley, olive leaves, roselle, and garlic can lower blood pressure and support heart health.
All in all, prescription medication should be a last resort, not the first line of treatment. As with most of my recommendations, use natural remedies, eat a healthy diet, practice common sense, and don’t believe everything (or anything) you hear from the mainstream.
For more detailed, step-by-step instructions on the above recommendations—as well as even more drug-free, science-based recommendations for preventing heart disease—refer to my Heart Attack Prevention Repair and Protocol. You can learn more about it or enroll today by clicking here or calling 1-866-747-9421 and asking for code EOV3U200.
2“Pharmacologic Treatment of Hypertension in Adults Aged 60 Years or Older to Higher Versus Lower Blood Pressure Targets: A Clinical Practice Guideline From the American College of Physicians and the American Academy of Family Physicians.” Ann Intern Med. 2017;166(6):430-437.
3“A Randomized Trial of Intensive versus Standard Blood-Pressure Control.” N Engl J Med 2015; 373:2103-2116.