TODAY'S DOSE OF POSITIVE HEALTH
“Knowledge is an unending adventure at the edge of uncertainty.” Jacob Bronowski
When drugs lowering blood pressure came first on the market in the early 60s, many doctors didn’t know how to use them. Guidelines were not available, and most physicians believed that systolic pressure should be measured according to a simple equation: 100 plus a person’s age. Many were convinced that as we get older our blood vessels get stiffer, and the systolic pressure naturally goes up to help push blood through the stiff vessel.
This concept was disproved in 1967 when a groundbreaking study comparing the drugs with a placebo showed that blood pressure medications significantly decrease the risk of heart attacks and strokes and have a great potential to save millions of lives. Because most clinical trials over the past few decades haven’t looked at a systolic pressure, the data remains insufficient.
The first research on systolic pressure published in 1991 concluded that to prevent heart attacks and strokes, the treatment goal should be the level of pressure below 150. Since then the vast majority of studies were looking to examine the outcomes for higher goals.
This caused major confusion, as although the data was consistent regarding systolic pressure being linked to a lower cardiovascular risk when kept below 120, many doctors were unsure if prescribing drugs to reach that level would actually show any benefit. We know that drugs can’t be used selectively. In other words, any drug would always have more effects on the body than the particular reason it is being used for. Lowering pressure down to 120 with drugs is not the same as a naturally low blood pressure of 120.
So, the question remains: how low should blood pressure go?
The guidelines are inconsistent. The National Heart, Lung and Blood Institute suggests that the benefits of treatment are seen when a systolic pressure is below 150 for people over the age of 60. When the results were presented in 2013, a few committee members strongly disagreed and published their own papers independently recommending blood pressure below 140 for people at the highest risk of hypertension. The American Heart Association says that it should be under 140. Both institutions, however, don’t take into account individual cardiovascular risks.
The European guideline is more precise and says that we should aim for a systolic pressure below 150 (except for the elderly), and measure a risk score for heart disease when deciding how low that number should go.
Many epidemiological studies suggest that adults with a systolic pressure 120 or lower have been at the lowest risk of having a heart attack or stroke.
Probably one of the weakest points of the current guidelines is that they are looking only at blood pressure as though it was a problem isolated from other important factors like daily lifestyle choices or the level of blood cholesterol. Some people are at higher risk than others even though they have the same blood pressure, yet they are supposed to be treated the same way aiming for the same pressure target. That’s confusing.
Reducing high blood pressure is often possible with modifying the food we eat and encouraging modest exercise, like walking. Adding more drugs to meet the target of 120 may not be the best move if the lifestyle remains the same. In fact, the side effects may outweigh any benefits. Older people are particularly vulnerable as many are being treated for at least one coexisting chronic condition that may cause drug interaction, dizziness and falls.
Despite years of research, we still don’t know how low blood pressure should go and how aggressive the treatment should be. The results from one of the largest clinical trials to date may bring more clarity.
The research was expected to be presented in 2017, but it has already ended as the data is conclusive enough to be published. The study was following more than 9,000 people over the age of 50 with high blood pressure and high risk of heart disease, looking at whether lowering a systolic pressure below 120 (the lowest level ever suggested) or below 140 may have a bigger impact on decreasing the risk of heart attacks, strokes, kidney problems and dementia. The full data will be published within the next few months.
In this fog of uncertainty one thing remains valid. Making more conscious choices when it comes to food, walking as often as possible and managing stress efficiently is more likely to improve our health than any drug alone could ever do.
Blood Pressure - a Fog of Uncertainty
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WEEK 7 - The Philanthropist
Create, Contribute,Thrive and Flourish
In today's class you will learn:
1. What is normal blood pressure
2. What are the current blood pressure recommendations
3. How to treat high blood pressure efficiently
When you finish today's class, click the golden button below and take another extra small action!
Positive Health Principle #46
YOUR WEEKLY SESSION
Get ready for your weekly session.
In your sixth session you will explore how to express yourself in service to others and set the following intentions:
1. Trust Your Self
2. Use your personality and self-expression in service to the world
Answer the questions in the Self-Trust Worksheet (download No1), and go through the exercises (download No2) before your next session. Evaluate your session in the Self-Evaluation Worksheet (download No3).
1. Please make sure that you choose a convenient time and a quiet place for your Skype conversations.
2. Let the members of your household know when you need time for yourself, so you are not being interrupted.
3. Check your wifi connection and show up on time.
4. If you are unable to attend, you can still reschedule within the next few days before the Monday of the following week, if your guide has a free time slot.
5. Your one-to-one sessions are an integral part of the Grace School curriculum. It is, therefore, fundamental that each session is in synchrony with the weekly Grace School module.
YOUR WEEKLY DOWNLOADS
All files attached below have been created to support and enhance your learning experience.
These are available for download for the next 7 days. Please make sure that you create your account to answer the questions in the Self-Trust Worksheet (No1), and do the exercises (No2) before your next session.
Use the Self-Evaluation Worksheet (No3) after your session. At the end of the week reflect on your experiences and challenges. Summarise your week with the Self-Reflection Worksheet (No4).
Your WEEK 7 Downloads:
1. Self-Trust Worksheet - identify how much you can trust yourself (approx. time 10 minutes)
2. Exercise Worksheet - do the exercises before your next session (approx time 10 minutes)
3. Self-Evaluation Worksheet - evaluate your session and learn from your experience (approx time 10-15 minutes)
4. Self-Reflection Worksheet - at the end of the week reflect on your experiences and challenges (approx time 10-20 minutes)