Blood Pressure and Lipid Guidelines for the Elderly? Useless.
by David Brownstein, MD
http://blog.drbrownstein.com/blood-pressure-and-lipid-guidelines-for-the-elderly-useless/
At age 70–or 60, 50 or even 40– should you have the same blood pressure that you had at age 20? Many conventional doctors and most of the Powers-That-Be feel that the answer to that question is “yes”. Conventional medicine loves to issue guidelines. They have issued guidelines concerning weight, lipid and blood sugar levels and blood pressure. New guidelines inevitably result in millions of new patients requiring millions of new prescriptions. Big Pharma loves new guidelines.
To be fair, the Eighth Joint National Committee recently released a new report on hypertension where the guidelines for diagnosing hypertension were slightly relaxed. The committee recommended that for those 60 years and older, the goal for blood pressure was to be less than 150/90mmHg, which is increased from the previous recommendations of 140/90. I am happy the committee raised the numbers, but they did not go far enough.
What is my opinion on these recommendations? For a healthy sixty year old, a blood pressure of 150/90mmHg should not considered elevated. In fact, it is an average blood pressure for someone age 60. To release a guideline that states this is the highest it can go before a person needs medication is ludicrous. What about someone who is 80 years old? An 80 year old will generally have a higher blood pressure when compared to a 60 year old because his/her blood vessels are less pliable. I do not think a healthy 80 year old patient with a blood pressure of 160/90 needs any antihypertensive medications.
This blog post was written in response to an article in Family Practice News (February 15, 2014) titled, “Intensive blood pressure, lipid control didn’t slow cognitive decline.” I would like to ask the question, “Why would anyone think that intensive blood pressure or lipid control would slow cognitive decline?”
As we age, blood pressure naturally increases. Why does that occur? Blood pressure naturally increases as we age because the blood vessels are less pliable. Therefore, as we age, we need an increased blood pressure to perfuse the body. In the elderly, if the blood pressure is too low or they are overprescribed anti-hypertensive medications, they may not pump enough blood to the brain. This can lead to brain fog, dizziness and falls.
Similarly, aggressive lipid lowering with statins and other medications can (and should) be predicted to cause brain problems. The brain has one of the highest concentrations of fat in the body. Lowering lipid levels by using drugs that poison crucial enzymes should lead a reasonable person to predict that using these drugs will result in a decline in brain function. That is exactly what happens with the use of lipid-lowering medications. In fact, the use of lipid-lowering medications has never been shown to increase longevity in the elderly.
What can you do? Be cautious if your health care provider is prescribing too many medications. And, if you are taking medications that are causing problems with your brain, seek another opinion. Remember, you are ultimately in control of your own health care decisions.
Are there other options to control elevated blood pressures and lipid levels? Yes! Start by cleaning up your diet—avoid refined food including items made from refined sugar, flour, salt, and oil. Eat a whole food diet free of hormones and pesticides. Drink adequate amounts of water and exercise daily. Walking is an excellent way to exercise. Following these simple steps will lesson your chances of developing hypertension or lipid abnormalities.
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