Don't over-medicate high blood pressure
There are still many practitioners treating patients for hypertension who believe that systolic blood pressure should be suppressed to less than 130 mm Hg with medication. Another study just published in JAMA (The Journal of the American Medical Association) adds more evidence that this is not helpful even for individuals with diabetes and coronary artery disease. The authors set out to:
"...determine the association of systolic BP control achieved and adverse cardiovascular outcomes in a cohort of patients with diabetes and CAD (coronary artery disease)."
They analyzed data for 6400 subjects from 862 sites in 14 countries for more than ten years.
"Patients received first-line treatment of either a calcium antagonist or β-blocker followed by angiotensin-converting enzyme inhibitor, a diuretic, or both to achieve systolic BP of less than 130 and diastolic BP of less than 85 mm Hg. Patients were categorized as having tight control if they could maintain their systolic BP at less than 130 mm Hg; usual control if it ranged from 130 mm Hg to less than 140 mm Hg; and uncontrolled if it was 140 mm Hg or higher."
The data they accumulated painted this picture:
"...little difference existed between those with usual control and those with tight control...The all-cause mortality rate was 11.0% in the tight-control group vs 10.2% in the usual-control group; however, when extended follow-up was included, risk of all-cause mortality was 22.8% in the tight control vs 21.8% in the usual control group."
Note that the tight control group had a slightly higher risk of all-cause mortality over the longer time period. Besides the greater likelihood of adverse effects with higher doses of medication, lower blood pressure means diminished delivery of oxygen to tissues (the pressure acts to overcome the increased resistance of less a healthy circulatory system).Their conclusion clearly states the lack of benefit with suppression to less than 130 mm Hg:
"Tight control of systolic BP among patients with diabetes and CAD was not associated with improved cardiovascular outcomes compared with usual control."
See another recent study that proves the same point.