They try their best to keep BP at levels of 120/80 by enforcing a pharmaceutical regime with all its side effects.
But isnt it more realistic to accept that as humans age their blood vessels and its walls wont be as supple and pristine and that BP levels will rise with age as a natural and normal byproduct of ageing.
So should 150/100 be considered as normal for the over 50s.
Is there a case for amending medical text books
Unless you want having a stroke to be the norm, i’m thinking maybe not?
Basically high blood pressure is something that AFAIK, is a contributing component to a lot of other diseases- what’s called a “primary risk factor”, meaning that it is a condition that in part, causes other diseases.
Stuff like diabetes, heart disease, metabolic syndrome, kidney problems, etc… are all exacerbated by high blood pressure.
Then it directly causes things like strokes and aneurysms- I’m guessing more as people get older and their arteries are less flexible.
They almost certainly reach their 120/80 guidelines by way of studies and statistics- there’s probably something out there that says if people have BP under 120/80, they reduce the likelihood of X, Y and Z by Q percent or something.
Current BP goals are not so stringent as described above.
Broad generalization with many exceptions follows:
Low/normal risk folks with isolated hypertension should have blood pressures at or below 140/90.
Those with higher risk conditions such as CAD or DM history (to name only a few of the diseases for which lower BP is desirable) should have BPs less than 130/90.
But the need for treatment/further drugs needs to be an individual decision, taking in the patient’s overall situation, not just one diagnosis. Some treatments are worse than the condition it is treating, in a given individual.
But the bottom line is: Maintaining blood pressure at or under target will definitely reduce death and disability in the overall population by a very significant amount. This is why it gets so much attention.
It also should not be based on one or just a few measurements, which most often are done without the best or correct technique. The prevalence of White coat hypertension is significant.
To what extent is it a cause, as opposed to a co-symptom? That is to say, if high blood pressure is caused by, for instance, a lack of exercise, then the lack of exercise might cause other problems, and reducing blood pressure through exercise might prevent those problems, but reducing blood pressure via medication might not.
Cause and effect is pretty clear; higher pressures result in greater risk of atherosclerotic lesions, risk of arterial ruptures, formation of micro and macroaneurysms, development of proteinuria, etc. And reduction in those pressures via weight loss, aerobic activity, and medication use is likewise associated in reduction in risk/rate of those complications.
We are now becoming more aware of the risks of reducing elevated blood pressures too rapidly too, though. If I’ve got an elderly gent whose BP has been running 190/110 for the last few days/weeks, one of the worst things I can do for him is drop it down to 130/90 too quickly. That can cause cerebral ischemia and even stroke, renal hypoperfusion, worsening of angina etc. all too quickly. I’d rather get him to 160/100 over the next couple of days, and slowly move to better numbers from there.
Sometimes the only symptom of high blood pressure is high blood pressure … and high blood pressure is a killer … Qadgop can correct me but I think this is easily and cheaply treated … Chlorothiazide hasn’t had patent protection for many many years …
Just a quick question: my girlfriend suffers from orthostatic hypo-tension. I’ve recommended that she supplement with salt, in the form of adding it to food/water on a daily basis. She also has low normal BP, 90-100/60 range. Is my recommendation a sound one or am I off base?
Is she symptomatic?
I’ve often had BP as low as 100/60 but it’s completely without symptoms, no lightheadedness or anything like that, so no doctor has felt a need to treat it. The FAA had some concern about my being on the low end of normal but again, no symptoms and I never had problems pulling g’s while flying. In other words, in my case it’s unusual but not considered pathological. (now that I’m my 50’s, and given the extreme stress of the past year, it’s getting more common for me to have a BP as “high” as 110/70, but clearly I’m still on the low end of normal)
If she is having symptoms, though, that’s a different matter and there’s a bunch of different things to try from drinking more fluids (you definitely want to avoid dehydration with hypotension) to adding salt to compression stockings (presumably if there are problems with leg circulation and return of blood to the heart) to… well, probably a bunch of other stuff. Apparently there’s more than one cause of problematic low blood pressure. You’d want her to have the proper treatment for the proper cause.
Please tell me she’s seeing a doctor about this if she’s having symptoms.
Given that her hypotension is orthostatic, she only has momentary symptoms of lightheadedness when she stands up from a seated position. I agree she should probably see a doctor but she doesn’t feel that it is serious enough.
“Lightheadedness when standing up” technically is a symptom. Next physical she should say something to the doc.
If she starts fainting she should definitely get this looked into.
Of course, if Qadgop says something other than what I did do what he says - he’s the actual doctor here.
I can only answer for myself.
I just use salt on food (use not = go nuts)
Sometimes my BP will be in the 80 something over 56 area.
I can do the jump up off the floor and make the world go away thing, im used to it doesn’t phase me, been that way since i was a kid.
Pull some positive G’s and im going nappy time if im not expecting it.
So i cant fly top gun 
There was some medicine they could give me for low BP
No fun, made me feel sick, rather throw some salt on my food.
There is also a physical way to counter the momentary stand up thing.
She can do the high G exercise pilots do, which kind of equates trying to forcefully combat constipation.
Keeps the blood from quickly leaving your top end.
She should see the Doc though just to make sure there isnt anything else other than just low BP
Has she always been this way? or is it something new?
Me, ive always been this way
My BP was 165/105 as far back as I could remember.
For those aware of my current medical situation, this is a giggle:
I refused medication because I did not want to be tied to a damned pill for the rest of my life.
When it got to 165/120, I allowed the doc to try meds.
I now have kidney failure - most likely due to hypertension.
The bradycardia got rid of the BP meds. Yea bradycardia!
I’m WAY past 50 and my blood pressure is way lower than 150/100. In fact, it’s lower than 120/80 and has been my entire life.
From my point of view, there’s no reason to amend the medical textbooks. For that matter, if they want to define the standard lower, that’s fine by me.
My BP is readily controlled in the 110-120/75-80 range using ordinary medicines. My wife’s is not, although it is at 140/90. The doctor is satisfied not to take extraordinary measures with her. He says the latest guidelines, based on stats, suggest that is correct.
High blood pressure is called the silent killer. From http://www.medicinenet.com/script/main/art.asp?articlekey=13118:
It may seem obsessive, but the consequences are many and irreversible. It is such a easy thing to control. You don’t want to suffer with the consequences. You want to do something about it while you can.
My doctor’s orders when he gave me that diagnosis was “you know how we tell everybody to cut down on the smokes, alcohol and salt? Well, don’t smoke and don’t drink, but do carry salty snacks and shake that shaker.” But that was 34 years ago. Middle age has raised my BP so that nowadays it’s normal; 90/60 used to be my high days.