Active Low-Carber Forums
Atkins diet and low carb discussion provided free for information only, not as medical advice.
Home Plans Tips Recipes Tools Stories Studies Products
Active Low-Carber Forums
A sugar-free zone


Welcome to the Active Low-Carber Forums.
Support for Atkins diet, Protein Power, Neanderthin (Paleo Diet), CAD/CALP, Dr. Bernstein Diabetes Solution and any other healthy low-carb diet or plan, all are welcome in our lowcarb community. Forget starvation and fad diets -- join the healthy eating crowd! You may register by clicking here, it's free!

Go Back   Active Low-Carber Forums > Main Low-Carb Diets Forums & Support > Low-Carb Studies & Research / Media Watch > LC Research/Media
User Name
Password
Register FAQ Members Calendar Mark Forums Read Search Gallery My P.L.A.N. Survey


Reply
 
Thread Tools Display Modes
  #1   ^
Old Tue, Nov-14-17, 03:49
JEY100's Avatar
JEY100 JEY100 is offline
To Good Health!
Posts: 9,549
 
Plan: IF Fung/LC Westman/Primal
Stats: 222/171/169 Female 5' 9"
BF:45%/25.3%/24%
Progress: 96%
Location: NC
Default New guidelines classify nearly half of U.S. adults as having high blood pressure

Here we go again...lower the guidelines and create millions more who "need" medication. This story was everywhere in the US, including on the major evening news outlets of NBC, CBS, etc. Major newspapers Washington Post https://www.washingtonpost.com/news...nes-in-14-years etc. The Chicago Tribune version quoted:http://www.chicagotribune.com/news/...-story,amp.html

Quote:
New guidelines lower the threshold for high blood pressure, adding 30 million Americans to those who have the condition, which now plagues nearly half of U.S. adults.

High pressure, which for decades has been a top reading of at least 140 or a bottom one of 90, drops to 130 over 80 in advice announced Monday by a dozen medical groups.

The change means an additional 14 percent of U.S. adults have the problem, but only 2 percent of these newly added people need medication right away; the rest should try healthier lifestyles, which get much stronger emphasis in the new advice. Poor diets, lack of exercise and other bad habits cause 90 percent of high blood pressure. "I have no doubt there will be controversy. I'm sure there will be people saying 'We have a hard enough time getting to 140,'" said Dr. Paul Whelton, a Tulane University physician who led the guidelines panel.

But the risk for heart disease, stroke and other problems drops as blood pressure improves, and the new advice "is more honest" about how many people have a problem, he said.

Currently, only half of Americans with high blood pressure have it under control. The upper threshold for high blood pressure has been 140 since 1993, but a major study two years ago found heart risks were much lower in people who aimed for 120. Canada and Australia lowered their cutoff to that; Europe is still at 140 but is due to revise its guidance next year.

The guidelines were announced Monday at an American Heart Association conference in Anaheim. What the changes mean

The guidelines set new categories and get rid of "prehypertension":
—Normal: Under 120 over 80
—Elevated: Top number 120-129 and bottom less than 80
—Stage 1: Top of 130-139 or bottom of 80-89
—Stage 2: Top at least 140 or bottom at least 90 That means 46 percent of U.S. adults have high pressure (stages 1 or 2) versus 32 percent under the old levels. How common it is will roughly triple in men under 45, to 30 percent, and double in women of that age, to 19 percent.

For people over 65, the guidelines undo a controversial tweak made three years ago to relax standards and not start medicines unless the top number was over 150. Now, everyone that old should be treated if the top number is over 130 unless they're too frail or have conditions that make it unwise. "The evidence with this is so solid, so convincing, that it's hard to argue with the targets," said Dr. Jackson Wright, a guidelines panel member from University Hospitals Cleveland Medical Center. Older people "have a 35-to-50-fold higher risk of dying of a heart attack or stroke compared to younger people."

But the Cleveland Clinic's Dr. Steven Nissen said he's worried. "Some more vulnerable patients who get treated very aggressively may have trouble with falls" because too-low pressure can make them faint, he said.

Who needs treatment

Certain groups, such as those with diabetes, should be treated if their top number is over 130, the guidelines say. For the rest, whether to start medication will no longer be based just on the blood pressure numbers. The decision also should consider the overall risk of having a heart problem or stroke in the next 10 years, including factors such as age, gender and cholesterol, using a simple formula to estimate those odds.

Those without a high risk will be advised to improve their lifestyles — lose weight, eat healthy, exercise more, limit alcohol, avoid smoking. "It's not just throwing meds at something," said one primary care doctor who praised the new approach, the Mayo Clinic's Dr. Robert Stroebel.

If people continue bad habits, "They can kind of eat and blow through the medicines," he said. The guidelines warn about some popular approaches, though. There's not enough proof that consuming garlic, dark chocolate, tea or coffee helps, or that yoga, meditation or other behavior therapies lower blood pressure long-term, they say.

The government no longer writes heart guidelines, leaving it to medical groups. Unlike previous guideline panels, none on this one have recent financial ties to industry, although some on a panel that reviewed and commented on them do. The guidelines were published in two journals — Hypertension and the Journal of the American College of Cardiology.

How and When to check it.

Blood pressure should be checked at least once a year by a health professional, and diagnosing high pressure requires 2 or 3 readings on at least two occasions.

The common way uses a cuff on the upper arm to temporarily block the flow of blood in an artery in the arm and gradually release it while listening with a stethoscope and counting sounds the blood makes as it flows through the artery. But that is prone to error, and many places now use automated devices.

The guidelines don't pick a method, but recommend measuring pressure in the upper arm; devices that work on fingers or are worn on wrists "aren't ready for prime time," Whelton said.

Home monitoring also is recommended; devices cost as little as $40 to $60.

What about kids?

Unlike adults, numbers for normal pressure in children vary with age, height and gender. Kids should be checked at least once a year for high pressure, say guidelines announced in August by the American Academy of Pediatrics.

After age 13, the levels defining high pressure are the same as for adults, said a member of the pediatrics panel, Dr. Elaine Urbina of Cincinnati Children's Hospital Medical Center.

"When you turn 18 years and one minute, you shouldn't suddenly have a new definition," she said.



One thing the Tribune article missed on the How and When part, is covered by People's Pharmacy....patient should sit quietly for five minutes before taking the Reading [how often does that happen?!]

Quote:
What Will the New Guidelines Mean for You?

The new guidelines will urge treatment for anyone whose ten-year risk of a heart attack or stroke is 10 percent or more. That will include most people over 65, whose age alone puts them at risk of problems within the next decade. But younger people with additional risk factors such as diabetes or kidney disease will also qualify for antihypertensive treatment.

Measuring Blood Pressure: Doctors and nurses may have to change the techniques they use to measure blood pressure at an office visit. The new guidelines recommend that patients be given at least five minutes of rest time before the measurement is made. No decisions are to be made on a single measurement; at least two, from two different office visits, are required for diagnosis. And patients are encouraged to monitor their own blood pressure at home. (You can find more information on proper blood pressure measurement technique here.)
https://www.peoplespharmacy.com/201...-blood-pressure

A related article from People's Pharmacy about HCTZ, the most commonly prescribed diuretic type blood pressure medication...it is not benign! Two side effects are Gout and High Blood Sugars, increasing the risk of diabetes. Also electrolyte imbalances leading to muscle spasms, Low BP incidents (dizzy, fainting, passing out while driving, using machines), etc. Many side effects with HCTZ which doctors have downplayed in some cases in this article.
And because a LC diet is already diuretic, it is important for anyone on this forum to carefully monitor BP when starting LC.
Guide to LC if on BP meds: https://www.dietdoctor.com/low-carb...ure#more-241392

Guide to HCTZ:https://www.peoplespharmacy.com/201...ations-and-gout

Last edited by JEY100 : Tue, Nov-14-17 at 05:57.
Reply With Quote
Sponsored Links
  #2   ^
Old Tue, Nov-14-17, 06:24
JEY100's Avatar
JEY100 JEY100 is offline
To Good Health!
Posts: 9,549
 
Plan: IF Fung/LC Westman/Primal
Stats: 222/171/169 Female 5' 9"
BF:45%/25.3%/24%
Progress: 96%
Location: NC
Default

Later from MedPage...Related to this big announcement at the AHA....Heart Attack Fells AHA President During Annual Meeting

Quote:
ANAHEIM -- The president of the American Heart Association, John Warner, MD, 52, had a "mild heart attack" on Monday morning, according to the AHA. Warner received a stent at an undisclosed hospital. The AHA said he is "doing well."
The attack occurred during the AHA's annual scientific sessions meeting here. The first indication of problems occurred early today when the AHA announced that Warner would not be available to moderate a press briefing on new hypertension guidelines.
Warner, an interventional cardiologist, has been the CEO of UT Southwestern Hospital in Dallas since 2012. Warner has an MD from Vanderbilt University and a MBA from the University of Tennessee. He completed his residency training in internal medicine at UT Southwestern and his cardiology fellowship at Duke University.

No comment.
https://m.youtube.com/watch?v=WPv2KRg1_DQ

Later edit: DietDoctor story with the NYT article link and his Guidelines for Normalizing BP. https://www.dietdoctor.com/millions...-blood-pressure

Last edited by JEY100 : Tue, Nov-14-17 at 07:46.
Reply With Quote
  #3   ^
Old Tue, Nov-14-17, 07:08
cotonpal's Avatar
cotonpal cotonpal is online now
Posts: 3,350
 
Plan: very low carb real food
Stats: 245/128/135 Female 62
BF:
Progress: 106%
Location: Vermont
Default

Dr Gilbert Welch, in his book Over-Diagnosed:Making people Sick in the Pursuit of Health, warns against the dangers involved in lowering guideline like these. Lowering the threshold for treatment increases the likelihood of an adverse effect of treatment while perhaps only minimally increasing the possibility of benefit.

http://dartmed.dartmouth.edu/winter...g_the_rules.pdf

As a person who once took medication for high blood pressure and now has perfectly normal blood pressure thanks to eating lchf, this new guideline does not seem like a reasonable way to go or an advance in medical treatment.

Jean
Reply With Quote
  #4   ^
Old Tue, Nov-14-17, 08:45
thud123's Avatar
thud123 thud123 is online now
Senior Member
Posts: 4,216
 
Plan: ~25NC/IF
Stats: 342.2/003.4/000 Male 72 inches
BF:
Progress: 99%
Default

https://www.youtube.com/watch?v=WPv2KRg1_DQ

I don't know Mr. Warner's medical history but I wish him well. I'm sure the annual AHA meeting is stressful and likely exacerbated an underlying issue.

Let's take the opportunity not to throw rocks at the other glass houses. The circumstances and fallout of a Dr. Atkins death come to mind along with the propaganda it produced
Reply With Quote
  #5   ^
Old Tue, Nov-14-17, 09:11
Seejay's Avatar
Seejay Seejay is offline
Senior Member
Posts: 3,025
 
Plan: Optimal Diet
Stats: 00/00/00 Female 62 inches
BF:
Progress: 8%
Default

More of what I call "casino medicine." Medical treatment for indirect markers for gambling odds, oops I mean "risk", as opposed to treatment that actually fixes a cause or injury.

As in, watch out for when going to a health professional to get healthy is like going to the casino to get rich.

Nice to see there are options that do not include a health professional, such as lifestyle changes and home monitoring.
Reply With Quote
  #6   ^
Old Tue, Nov-14-17, 10:54
GRB5111's Avatar
GRB5111 GRB5111 is offline
Posts: 1,930
 
Plan: Ketogenic (LCHFKD)
Stats: 227/186/185 Male 6' 0"
BF:
Progress: 98%
Location: Herndon, VA
Default

I hope Dr. Warner has a full recovery. His experience is a classic example of people jumping to conclusions regarding the root cause of his heart attack. The symptoms are there, but the specific root cause is not known.

These new BP guidelines likely put me in the HBP category, as anything over 120/80 is now considered high and I'm over 65. I am already preparing for my next doctor visit in early January where I'm sure I'll be regaled with the recommended medications due to the redefined guidelines. I would love to understand the truth about blood pressure and know its role in overall health regarding the implications as to how it changes as one gets older. I read an article at one point recently that BP is regulated naturally based on the degree one needs to maintain health over the years. If we knew the role of BP without a shadow of a doubt, then we wouldn't have to treat it as a symptom as we do today based on association rather than causation. If firefighters are always at the scene of fires, are they the ones starting them?
Reply With Quote
  #7   ^
Old Tue, Nov-14-17, 11:31
Meme#1's Avatar
Meme#1 Meme#1 is online now
Senior Member
Posts: 7,902
 
Plan: Atkins DANDR
Stats: 210/183/160 Female 5'4"
BF:
Progress: 54%
Location: Texas
Default

I use to think that older people fall because they're frail but now I think it could have a lot to do with being overmedicated. It just doesn't make sense to take a pill to lower BP without monitoring several times per day to see it's effects.
What's the point...too low is probably just as bad as too high!
Reply With Quote
  #8   ^
Old Tue, Nov-14-17, 12:34
doreen T's Avatar
doreen T doreen T is offline
Forum Founder
Posts: 35,316
 
Plan: DANDR '92
Stats: 236/184/140 Female 165 cm
BF:
Progress: 54%
Location: Eastern ON, Canada
Default

My BP readings tend to be higher at the dr's office than at home. A lot higher, in fact. The previous dr. accepted readings from my home BP monitor (Omron), which has a 14-day memory. However, she's retired and the nurse at the new clinic refused to accept home readings .. even though a concurrent reading with their cuff AND mine at the same time gave exact same reading .

So I went back a few weeks later for a "True BP" session. This involves sitting with a BP cuff set to take a reading every 2 or 3 minutes for 15 minutes (or longer) .. then they take an average. At my session, I was stuck in a brightly lit room with doors banging shut and loud talk, and a screaming baby in the next room .. the only thing to look at was a giant poster ablaze with the warning signs of a stroke and how many Canadians die each year from undiagnosed or untreated high blood pressure . No big surprise, my "True BP" average was very high.

I stuck to my guns though, and requested a 24 hr ABP test (Ambulatory Blood Pressure). This involves wearing an automated cuff and monitor at home for 24 hrs .. the cuff inflates every 30 minutes during the day, and once per hour overnight. So my BP at home doing my normal daily activities was just fine .. average 115/70. The only high readings I got were at the beginning in the clinic when the monitor was first put on.

A follow-up consultation with a cardiologist confirmed my normal readings and that I do NOT need any medication. His expert opinion is that too many patients are put on meds by their family drs based on transiently high clinic readings. Then they suffer too-low BP episodes at home or at work, with dizziness, weakness and possibly even a fall causing injury.
He's a wise man, IMO

One thing I discovered with frequent monitoring at home is that coffee causes my BP to rise and it stays up for 2 to 3 hours afterward. Always returns to normal though. I've cut back to just one cuppa in the morning and from now on I'll make sure to schedule any clinic BP checks for later in the day

.
Reply With Quote
  #9   ^
Old Tue, Nov-14-17, 12:52
Meme#1's Avatar
Meme#1 Meme#1 is online now
Senior Member
Posts: 7,902
 
Plan: Atkins DANDR
Stats: 210/183/160 Female 5'4"
BF:
Progress: 54%
Location: Texas
Default

Quote:
Originally Posted by doreen T
At my session, I was stuck in a brightly lit room with doors banging shut and loud talk, and a screaming baby in the next room .. the only thing to look at was a giant poster ablaze with the warning signs of a stroke and how many Canadians die each year from undiagnosed or untreated high blood pressure . No big surprise, my "True BP" average was very high.



That is Deja Vu to me Doreen.
I was laughing my head off when I read that part!

Good for you being proactive to make the right decision for
your own well being!
Reply With Quote
  #10   ^
Old Tue, Nov-14-17, 12:54
cotonpal's Avatar
cotonpal cotonpal is online now
Posts: 3,350
 
Plan: very low carb real food
Stats: 245/128/135 Female 62
BF:
Progress: 106%
Location: Vermont
Default

Quote:
Originally Posted by doreen T
My BP readings tend to be higher at the dr's office than at home. A lot higher, in fact. The previous dr. accepted readings from my home BP monitor (Omron), which has a 14-day memory. However, she's retired and the nurse at the new clinic refused to accept home readings .. even though a concurrent reading with their cuff AND mine at the same time gave exact same reading .


My bp is always high at the doctor's office. This last time she told me to take my bp twice a day for a week at home and then bring the readings and my monitor in to be checked against theirs which I did. My at home reading were all normal and my monitor checked out. No muss no fuss no bother no medication.

Jean
Reply With Quote
  #11   ^
Old Tue, Nov-14-17, 13:00
cotonpal's Avatar
cotonpal cotonpal is online now
Posts: 3,350
 
Plan: very low carb real food
Stats: 245/128/135 Female 62
BF:
Progress: 106%
Location: Vermont
Default

Quote:
Originally Posted by Meme#1
I use to think that older people fall because they're frail but now I think it could have a lot to do with being overmedicated. It just doesn't make sense to take a pill to lower BP without monitoring several times per day to see it's effects.
What's the point...too low is probably just as bad as too high!


That's exactly Dr Welch's point. In many cases people are being overmedicated and suffering far more harm from the "side effects" than they are benefits from the medication.

Jean
Reply With Quote
  #12   ^
Old Tue, Nov-14-17, 13:33
bevangel's Avatar
bevangel bevangel is offline
Posts: 1,546
 
Plan: modified adkins (sort of)
Stats: 265/176/167 Female 68.5 inches
BF:
Progress: 91%
Location: Austin, TX
Default

Meanwhile, what to do about folks like my 87 y.o. father whose BP normally runs about 90 to 100 over 45 to 50 but, when taken in the doctor's office...usually within 15 seconds of him walking down the hall and sitting down in the exam room, it will sometimes show 135/65.

Low BP already tends to make Dad dizzy when he first stands up. But under the new guidelines, he's SUPPOSED to go on blood pressure lowering medication???

Fortunately, I think his doctor knows him (and me) well enough that he won't put him on BP meds just because the new guidelines suggest that he "ought" to be on them. And regardless, I'm the one who set Dad's meds in his pill box and and I simply WILL NOT give him any blood pressure lowering meds. Won't even bother to pick up such meds from the pharmacy if the doctor SHOULD order any.

But, how many other elderly people will needlessly suffer falls and the resulting broken bones - or worse - because unnecesary BP meds prescribed under the "new guidelines" make their blood pressure drop too low? Big Pharma doesn't need to worry about that tho because everybody knows old people fall a lot so a fall couldn't possibly be related to any medication they might be taking.
Reply With Quote
  #13   ^
Old Tue, Nov-14-17, 13:50
deirdra's Avatar
deirdra deirdra is offline
Senior Member
Posts: 3,722
 
Plan: HF/vLC/GF,CF,SF
Stats: 197/136/150 Female 66 inches
BF:
Progress: 130%
Location: Alberta
Default

My mother was on meds for high BP for what I always suspected was white coat syndrome. My parents were in "Independent Living" for a while and all the food was low salt. It seemed like every day I visited one resident or another was falling and being carted off by ambulance. My normal-weight mother fell twice, first breaking her hip, then hitting her head. We brought her to live with my sister, and only because she was having her blood pressure taken every other day by an RN, OT or PT did doctors allow us to wean her off two BP-lowering meds. Without the white coats, she had readings like ~55/35 - so low that two of them went out to their cars to bring in another BP monitor, assuming the first one was faulty. No, that's what no salt and salt-excreting meds do to a person! Needless to say, we got her off the meds and salted her food normally and she never fell or fainted again. She wasn't as low carb as me, but my sister's home is real foods South-Beachy.
________
Reply With Quote
  #14   ^
Old Tue, Nov-14-17, 16:55
teaser's Avatar
teaser teaser is online now
Senior Member
Posts: 11,451
 
Plan: ketosis/IF
Stats: 190/158/154 Male 67inches
BF:
Progress: 89%
Location: Ontario
Default

https://www.sciencedaily.com/releas...70809140228.htm

Quote:
Medical researchers at Trinity College Dublin, Ireland, are advising caution when treating blood pressure in some older people -- after results from a study contrasted with recent advice from the US to attempt to aggressively lower blood pressure in all adults to targets of 120mmHg.

Researchers from the Irish Longitudinal Study on Ageing (TILDA) at Trinity College Dublin, in collaboration with Beaumont Hospital, Dublin, have recently published the findings in the Journal of the American Medical Association (JAMA Internal Medicine).

A large randomised blood pressure trial led by US investigators -- the Systolic blood Pressure Intervention Trial (SPRINT) -- demonstrated that lowering systolic blood pressure to levels of 120mmHg or less compared with 140mmHg or less in adults (over 50 years with cardiovascular risk) significantly reduced death (from all causes and from heart failure and heart attacks). The study also reported that common side effects of low blood pressure such as falls, injuries, blackouts, and drops in blood pressure after standing were not increased by aggressive treatment -- even in people over 75 years old.

Because the latter findings were clinically counter intuitive, the TILDA team tested whether they held true outside of a trial setting. Focusing on people in Ireland over 75 years, they examined rates of falls, injuries, blackouts and excessive drops in standing blood pressure in those who met the criteria for the treatment proposed in SPRINT and were followed up with for 3˝ years -- the same time period as SPRINT.

The researchers reported starkly contrasting results -- falls and blackouts were up to five times higher than reported in SPRINT and drops in blood pressure on standing were almost double that reported in SPRINT. Therefore, in people over 75 years, intensive lowering of blood pressure to 120mmHg could result in harm and TILDA researchers recommend that a better understanding of who, over 75 years, will or will not benefit, is necessary before widespread adaptation of the SPRINT results.

The TILDA team is now assessing how best to determine which people may benefit from SPRINT, and which people are more at risk from aggressive blood pressure lowering.

First author of the journal article, Research Fellow at TILDA, Dr Donal Sexton, said: "SPRINT was a landmark study of hypertension treatment. While the benefits of lowering blood pressure seen in this study are not in dispute, we are highlighting to physicians that we need to be cognisant of the fact that the trial was not powered for adverse events such as falls causing injury. Physicians ought not to expect a similarly low rate of adverse events in clinical practice as was observed in the trial when lowering blood pressure in older people. Overall what we are saying is that the risks and benefits of lowering blood pressure should be individualised for each patient. "

Professor Rose Anne Kenny, founding Principal Investigator with TILDA and lead author of the journal article commented: "Our work and that of other groups has shown that low blood pressure and particularly drops in standing blood pressure are linked not only to falls, fractures and fall- and blackout-related injuries, but also to depression and possibly other brain health disorders."

"These outcomes can seriously impact on independence and quality of life and we advise caution in applying the SPRINT recommendations to everyone over 75 years without detailed assessment of an individual's risk versus possible benefit until such a time as we can provide more clarity re treatment."
Reply With Quote
  #15   ^
Old Tue, Nov-14-17, 17:22
cotonpal's Avatar
cotonpal cotonpal is online now
Posts: 3,350
 
Plan: very low carb real food
Stats: 245/128/135 Female 62
BF:
Progress: 106%
Location: Vermont
Default

Dr Davis's open letter to the AHA president:

http://www.wheatbellyblog.com/2017/...rt-association/

Jean
Reply With Quote
Reply

Thread Tools
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

vB code is On
Smilies are On
[IMG] code is On
HTML code is Off



All times are GMT -6. The time now is 15:01.


Copyright © 2000-2017 Active Low-Carber Forums @ forum.lowcarber.org
Powered by: vBulletin, Copyright ©2000 - 2017, Jelsoft Enterprises Ltd.