The REAL Problem with Blood Pressure Medication
I’ve just demonstrated that the side effects of most blood pressure medications are far more extensive than most people, physicians included, realize.
With any intervention, there is a balance of risk versus benefit. I’ve covered the risks in the previous section.
This leaves a discussion on the benefits.
But what if the benefits are not as great as we all think?
High Blood Pressure Medication Side Effects: New Drugs Not Helping?
Researchers have spent hundreds of millions of dollars to develop fancy new blood pressure lowering medications in an attempt to lower patients’ risk of stroke and heart attacks. This was all based on the idea that newer must be better (and more profitable).
Unfortunately for the companies that spent all that money, the ALLHAT trial (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack) Trial results were published in late 2002 that demonstrated that the cheapest and oldest class of drugs, the diuretics, work the best at preventing heart disease.
Despite the findings of this study, even a year later doctors viewed diuretics as less effective and were less likely to use them. The sad fact is that they were more likely to use drugs that they had been given samples to hand out.
In other words, it wasn’t about what worked better.
Rather, what doctors prescribe is more about what the drug reps are telling them than about what actually taking the time to stay current with the medical research.
Newer is not always better.
High Blood Pressure Medication Side Effects: Little Overall Effect
When the World Health Organization looked at overall blood pressure from the mid 80’s to the mid 90’s, they found that the overall blood pressure of the world had lowered.
This was a good thing. I’m sure that the drug companies believed that they had a collective role in the beneficial lowering of the world’s blood pressure.
When all the cards were laid out on the table looking at 38 world populations, blood pressure medication “made no detectable contribution to population decline in blood pressure in the mid-1980s to mid-1990s.”
Billions of dollars spent on blood pressure medications across the globe and it’s not really making a difference. Unless you own shares in big pharma.
High Blood Pressure Medication Side Effects: Surrogate End Markers
Medicine reliance on drugs and surgery has led to a situation where the entire structure of medicine is built on a house of cards.
This house of cards is not likely to come crashing down because the amount of money sustaining it is larger than the GDP of most countries.
So why do I think medicine is built on a house of cards? Because research and drug promotion rely very heavily on a concept call “surrogate end markers.”
In many cases, drug development is not based on preventing an actual disease because this would just take too long. Instead, drug companies set up trials to see if a drug will help with the risk factors of the disease.
Some examples include:
In many cases we see that the use of surrogate end markers in research leads to much-less-than-expected or even WORSE outcomes when we, years later, look at the disease we were trying to protect against.
Because so much of medical research is based upon the use of surrogate end markers, it leads to doctors and patients blindly thinking that there is solid research behind the use of a drug for preventing the DISEASE and not the MARKER.
What does all of this have to do with blood pressure medications?
Although there has been some fear with the direction this group has been taking since 2018, the Cochrane group has always been considered THE worldwide group that can tear apart the medical research on a topic and filter through the bad study designs and bias that can clog up the true results of a study.
In August of 2012 (yes…this is not new news) a review done by the Cochrane Collaboration found that there was NO EVIDENCE THAT DRUG TREATMENT OF HIGH BLOOD PRESSURE BELOW 160 SYSTOLIC AND 100 DIASTOLIC LED TO LOWER RATES OF STROKE, HEART ATTACK OR DEATH.
Let that sink in.
High Blood Pressure Medication Side Effects: Summary
Seven years ago (at the time of writing this) a practice-shattering review determined that there was no evidence to suggest that the vast majority of use for blood pressure medication does anything to help.
The response from the medical community? Crickets chirping.
Is this surprising?
This is a LOT of money we’re talking about here.
In the years since this Conchrane study, I have yet to see a patient come in with blood pressure below 160/100 whose doctor took them off of blood pressure medications as a result of this study.
The sad part is that I don’t think that these recommendations are going to be widely adopted. Dogma rules in medicine; it takes decades to change behaviors.
What does all of this mean?
I’ve talked about risk versus benefit. In stage one hypertension (below 160 and / or below 110) there is NO benefit. This means that any risk is too much.
In the previous section I pointed out that the list of side effects from blood pressure medications is extension and greater than most patients and doctors realize.
In the end, lifestyle is the only answer. Using lifestyle to lower your blood pressure WILL lead to lowered rates of heart disease, stroke and death with no risk tied to these changes.
This next section will cover the lifestyle changes and supplements that have been shown to help with elevated blood pressure.