Shine OnCanadian doctors skeptical of new blood pressure guidelines
New blood pressure guidelines being discussed in the United States have thrown the Canadian medical community for a bit of a loop, with some claiming it could result in more strokes and heart attacks.
The new blood pressure guidelines, published Wednesday in the Journal of the American Medical Association, suggest that people over the age of 60 should only be treated for high blood pressure with a reading of 150 over 90, not the previously followed 140 over 90.
“The result is that many high-risk patients over 60 won’t be treated aggressively and, as a consequence, stroke rates and cardiovascular and kidney disease rates will probably rise,” Dr. Raj Padwal, a medical professor at the University of Alberta, tells the Toronto Star.
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Patients with high blood pressure, a condition which affects one in five Canadian adults, are advised to change their diet, lifestyle and sometimes take medication to lower the pressure on the heart.
Dr. Ernesto Schiffrin, a Canadian hypertension expert, argues the U.S. guidelines do not adequately take into consideration individual risk factors, such as medical history.
“[The recommendations] don't consider that many patients, after age 60, have elevated cholesterol, they may be smokers, they may be overweight or obese," he tells The Globe and Mail. "For those patients, perhaps a majority of patients above age 60, recommending blood pressures under 150 may be under-treating them."
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Schiffrin also says Canadian guidelines specifically account for high-risk and low-risk individuals, as well as include age-based recommendation for people over 80. The national goal for high-risk people is 140 over 90, while the goal for low-risk people is 160 over 100.
Proponents of the suggested recommendations say the goal is to decrease the number of baby boomers being prescribed blood pressure medications, which can have adverse side effects.
And yet some Canadian medical experts believe the idea of raising the blood pressure guidelines may be worth exploring as there should be a "grey area” in hypertension treatment.
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“As we get older our blood pressure increases – this is just part of the aging process," says Dr. Peter Liu, the scientific director of the University of Ottawa Heart Institute. "If that’s the only thing that you have, then trying to bring down blood pressure may not be realistic or necessary.”
Dr. Jacob Udell, a cardiologist and spokesperson for the Heart and Stroke Foundation, says there was little evidence to support more aggressive treatment in people over age 60.
“If we get too aggressive with blood pressure when we’re over an advanced age . . . sometimes we can do more harm than good, because low blood pressure can have side-effects too,” he says.
