The mantra for treatment for high blood pressure has been "the lower, the better," but that goal can potentially put patients at risk of kidney failure or death, according to a Kaiser Permanente study published today in the Journal of the American College of Cardiology.
Researchers examined the electronic health records of nearly 400,000 Kaiser Permanente patients in Southern California who were taking medications to treat high blood pressure from January 2006 through December 2010. They found that:
"Physicians have often emphasized the need to bring a patient's blood pressure down as low as possible for the best outcomes," said lead study author John J. Sim, MD, Kaiser Permanente Los Angeles Medical Center. "However, the findings of our study suggest that treating patients with high blood pressure too aggressively may potentially lead to poor health outcomes."
The results of this study also demonstrate a need to better understand the ideal target blood pressure ranges as well as the potential dangers of overtreating patients, according to the researchers.
"We hope our findings will pave the way for a more effective strategy in treating high blood pressure," said Dr. Sim. "Through personalized treatment plans, we can minimize the lifestyle burden on patients and improve the safety of their treatment regimens, while reducing the cost to both patients and the health care system as a whole."
According to National Institutes of Health, one in three people in the United States has high blood pressure, costing almost $94 billion in health care services, medications and missed days of work. High blood pressure can also lead to an array of complications, including kidney damage, heart disease and stroke. Although current treatment guidelines recommend that adults between 30 and 59 years old with hypertension should aim for a target blood pressure below 140 systolic and 90 diastolic, they do not refer to the dangers of having a patient's blood pressure drop below a certain level. Additional research could lead to more accurate guidelines aimed at safeguarding patient health.
Kaiser Permanente is a national leader in reducing and preventing heart attacks and strokes. In 2012, Kaiser Permanente Colorado was recognized by the U.S. Department of Health and Human Services as the 2012 Hypertension Control Champion by Million Hearts™. Additionally, Kaiser Permanente Northern California boosted its hypertension control rate from 44 percent to 80 percent over an eight-year period by using many best-performing clinical practices, such as establishing a hypertension registry, improving medication adherence with email and phone reminders, and making blood pressure measurement readily available.
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