Sunday, 27 October 2013

Kendrick on Blood Pressure

After my brief run in with hypertension I still look to monitor my BP readings.  Malcolm Kendrick has put up another superb piece on the measurement of BP and a few other passages that calm anyone who is tarred with the 'lower is better' broad brush.

My readings have fallen massively since I've resolved the underlying cause (sleep quality/'cold-showers & cortisol').  My BP is still very dynamic but morning and evening readings regularly touch sub-120/sub-75.  Resting pulse is often in the low 40s.  I am happy with where I am, and improving sleep quality seems to have brought a host of other benefits.

The reason for this post is to draw attention to something in Kendrick's post that really stood out, to do with 'a series of bullet point in the European Journal of Cardiology entitled ‘There is a non-linear relationship between mortality and blood pressure’':
  • •Drugs that lower the blood pressure by about the same amount have very different effects on outcomes

    •Cardiovascular benefits of ACE-inhibitors (Angiotensin Converting Enzyme – Inhibitors), independent of blood pressure, are not observed with calcium antagonists, despite the latter having more pronounced effects on blood pressure.

    •HOPE (Heart Outcomes Prevention Evaluation study) demonstrated that ACE inhibitors provided diverse and profound cardiovascular benefits, with only trivial differences in blood pressure between the treatment and control groups

    •ALLHAT (Antihypertensive and Lipid Lowering treatment to prevent Heart Attack Trial) showed a dramatic difference in cardiovascular risk between alpha blockers and diuretics, with essentially no difference in their effect on blood pressure. The investigators of ALLHAT concluded ‘blood pressure lowering is an inadequate surrogate marker for health benefits in hypertension.
We're big fans of MK here at Natural Messiah.  His reputation continues to grow!

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