Millions of people suffer from high blood pressure or hypertension according to WHO and most of them have to take medicines to control their blood pressure. Two new findings can have an impact on hypertensive patients. One is about the actual blood pressure reading numbers for which medicines need to be taken and the other is how and when medicines are taken.
Why are blood pressure numbers important?
Blood pressure number readings tell the healthcare practitioner if your blood pressure is within the normal range or not. If it is consistently high and not linked to your medical history (occasional high readings may occur if the patient is suffering from stress, trauma or even an illness) you may need medications to bring it down to normal levels, if it is really high. However, most doctors prefer lifestyle changes (diet, exercise, stress reduction) as the first line of treatment and prescribe medications only if these don’t work or they don’t reduce the pressure readings substantially.
These levels can be significant and they set the parameters regarding or not whether a patient requires any treatment. High blood pressure numbers typically are 140/90 and above. A reading of 140 of the systolic pressure consistently regardless of the lower number is indicative of high blood pressure. Similarly a reading of 90 or more of the diastolic pressure regardless of the top number is also indicative of high blood pressure. This is the standard that most doctors based their medical advice on, also taking into account the individual’s complete medical condition and history. The fact is that even a slight deviation on the higher side of normal increases the patient’s risk of suffering from high blood pressure related ailments like heart disease and stroke exponentially.
Are these numbers set in stone?
This is where the problem lies: these numbers are at best fluctuating and keep changing as there is no set standard. What’s more there is a great deal of controversy regarding the actual figures. A recent study published on December 18, 2013 in JAMA titled 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults and authored by Paul A. James, William C. Cushman, Suzanne Oparil and other panel members appointed to the Eighth Joint National Committee (JNC 8) used rigorous evidence-based methods, developing evidence statements and recommendations for blood pressure.
The experts used randomized controlled trials and based their recommendations accordingly. They said that people of 60 and older ought to consider figures of 150/90 as normal and should aim for readings below these figures. If the recommendations of this study are followed, then it means that large numbers of people who are on medication for managing their high blood pressure even if it was above 140/90 may have unnecessarily taking medicines. But the story does not end here. Some experts who took part in this study later retracted and said that the old number of 140/90 still held good and that doctors and patients should follow the old guidelines.
Where does this leave the patients of hypertension?
When medical experts are unsure of their recommendations, it leaves patients even more confused. While it is clear that higher blood pressure levels definitely need to be treated those who fall in between the two supposedly normal levels need to explore their options along with healthcare provider. Your doctor will have to check your medical history and take other parameters into account, including your lifestyle, fitness and diet before recommending medicines.
The time when blood pressure medicines are taken may impact their efficacy
As there are a range of blood pressure medicines that work in different ways, it is important to check how and when they are taken. An earlier study, published on October 25, 2011 in the Journal of the American Society of Nephrology suggested that taking blood pressure medicines in the night before sleeping may help reduce the risk of developing heart disease or stroke. This study, conducted by Spanish researchers, followed 661 men and women with slight kidney disease for five and a half years. Half of them were asked to take the medicine in the morning, while the other half took it at night.
At the end of the study period, the researchers said that those who took their medicine in the night were better able to manage their blood pressure and were at reduced risk of heart and stroke patients when compared to the group that took medicines during the day.
Effects of green tea on blood pressure medicines
Green tea is supposed to be healthy and has also been credited with reducing blood pressure levels naturally. However, a more recent report published in the journal Clinical Pharmacology & Therapeutics and conducted by Japanese researchers of Fukushima University followed ten healthy men and women debunked this theory. These participants were told to take 30 mg of Nadolol, a beta blocker used for controlling high blood pressure. They were also to take two cups of green tea in a day for two weeks. After that period they were told to take only water and not green tea.
The readings were surprising: the researchers found that when the volunteers were taking green tea, the effect of Nadolol reduced by as much as 76 percent. It appears that the chemicals in the green tea react with the medicine and reduce its efficacy. So people who are on this particular drug have been advised not to drink green tea. However, this study size was small and so larger studies are required before a cause and effect conclusion can be established.
If you are a patient of hypertension, you should talk to your healthcare provider regarding these new findings, particularly if you are a borderline hypertensive. However, if you have other risk factors or diseases, or have established high blood pressure, you should not change your medicines or stop taking them without consulting your doctor.
Harvard Health Publications
The Journal of the American Medical Association