Is a blood pressure less than 120/80mm Hg healthier than a higher blood pressure? Scientists randomly assigned 9,361 subjects with systolic blood pressure of 130 mm Hg or higher and increased cardiovascular risk, but without diabetes, to two groups. The intensive treatment group had a systolic blood-pressure target of less than 120 mm Hg while the standard treatment group had a systolic blood pressure target of less than 140mm Hg. This study is known as the SPRINT trial. The end point of the study was the difference in cardiovascular endpoints—heart attacks, stroke, heart failure or death from cardiovascular causes.
The study was stopped early at 3.26 years due to a 27% lowered all-cause mortality rate in the intensively treated group. Furthermore, there was a 25% lowered rate of the primary composite outcome—which is measured by averaging all the cardiovascular outcomes. (New England Journal of Medicine. November 9, 2015)
Comment:
When this study was released, the media released headlines that proclaimed that a lowered blood pressure is better than a higher blood pressure. The New York Times headline stated, “Lower Blood Pressure Guidelines Could Be ‘Lifesaving,’ Federal Study Says.”
Nobody knows what the optimal blood pressure values should be. I can assure you there is not one number that is optimal for everyone at every age. When I was in medical school, I was taught that normal blood pressure rises with age. This is still true. As we age, our arteries become stiffer therefore, we require a higher blood pressure to pump blood to the entire body. It is ludicrous to believe that an 80-year-old should have the same blood pressure as a 20-year-old. Setting blood pressure guidelines for everyone at 120 mm Hg or less guarantees that nearly every adult over the age of 40 will require a blood pressure medication in order to meet these guidelines.
What was not reported in the media was that the rate of serious adverse events including hypotension, syncope (fainting), electrolyte abnormalities and kidney failure were all significantly higher in the intensive versus the standard-treatment group. Each of these adverse events are well-known to occur when too many antihypertensive medications are prescribed and the blood pressure is lowered too much.
Furthermore, what was not reported in the media was the absolute risk difference between the two groups. The media reported the less-accurate relative risk difference—25% reduction in the primary cardiovascular endpoints and a 27% reduction in all-cause mortality. The more-clinically relevant absolute risk difference between the two groups was 1.6% in the primary outcome and 1.2% in the all-cause mortality. Therefore, in order to prevent any cardiovascular endpoint (stroke, heart attack, heart failure, death, etc,) you would need to treat 62 patients for 3.26 years to prevent one event. That means, the treatment group failed 98% (61 out of 62). Similarly, for all-cause mortality, you would need to treat 83 patients for the same time period to prevent one mortality. In this case, the treatment failed 99% since 82 out of 83 subjects received no benefit.
Finally, the difference between the intensive and the standard treatment group for all the primary outcomes was 0.54% per year. That means that if you are in the intensive treatment group, you will have a reduced chance of having a primary outcome (heart attack, stroke, death, etc.,) for 2 days for each year you take the antihypertensive drugs . So, if you take blood pressure medications for 30 years in order to lower your blood pressure below 120 mm Hg you will receive a primary outcome benefit of 60 days. When you factor in the serious adverse effects (mentioned above) of maintaining a very low pressure, I say fugetaboutit. This study is another example of the Powers-That-Be trying to scare us into taking more unnecessary drugs.
People only consume about half of the RDA for potassium on average, with urban dwellers getting even less than this, and deficiencies of this exist at the cellular level, where potassium does its work, and will only show up on a blood test when the deficiency is extreme. This is one nutrient that we don’t take the RDA seriously though. It’s been shown that if people do consume the RDA, 4.7 grams, this reduces blood pressure on average by about 8/4 mm Hg. Risk of cardiovascular disease and heart attack also is decreased significantly, by up to 155, independent of blood pressure. Hardly anyone talks about inadequate potassium in the diet though, in spite of its critical role in many processes, especially cardiovascular health. They even legislated a cap on supplements in the U.S., lest people try to help themselves that way. Beyond that, a prescription is needed, which is akin to needing a prescription for a potato. They only want you treating this when your life is truly in jeopardy though, other than that, get as sick as you want, we have things to give you, like high blood pressure and other CV related meds.
A good example of how numbers can be manipulated to create illusions. Even if we accept the findings, this does not mean that medication is ever indicated. There are often nutritional issues that underlie this, but they try to suppress this and tell us that deficiencies are rare in spite of strong evidence to the contrary. There are also natural supplements that help, and the number one effective treatment is probably dietary modification, not salt restriction but carb restriction, which has been shown to work as good or better than drugs. The goal here is to sell drugs though, not help people. So anything that doesn’t increase sales is called quackery, anyone who pushes anything but drugs are called quacks, even suggesting people change their diet gets you labeled as a quack, especially in the cancer field, where you are vilified for even suggesting people try to help themselves with diet. The only appropriate treatment for hypertension is to treat the causes, not the hypertension itself, but that would make people better, they certainly don’t want that, they want sheep they can fleece for life. People line up for this, being sheep by nature. I would never touch a BP med and have had high blood sugar but treated it naturally and now I average about 115/62, and it’s not because the high blood pressure is being suppressed, it’s because it’s no longer required. This is what we need to be shooting for and the only way you can do that is through natural medicine.
Dr. Brownstein,
I have been a follower of yours on bp. I am 50 yrs old always had high bp since in my late 20’s. I have been trying not to take bp meds but I got a UTI I think I’ve had it awhile anyway my bp got really high they put me on lisinopril & hydrochlorothiazide then an antibiotic that was in the ER. Went to the clinic talk to a nurse practitioner. Told me I would never get off these drugs I’m asking when I get a good diet and exercise plan is there a way to stop taking these bp meds with out getting a stroke, heart attack, etc. The nurse practitioner told me I would be on them the rest of my life. I don’t like the side affects. The bp meds make me feel sickly. Bless you on helping people go the right direction.
Dr. B, Thanks you so much for the time you take to educate those who want to know the truth. One of the comments mentioned above mentioned a doctor’s oath states “do no harm”. Another statement in their oath is to “not push prescriptions on their patients”. Do they no longer take the Hippocratic Oath? The kickback on
prescriptions must be very lucrative.
My husband has Ischemic heart failure. When first diagnosed he was given prescription for Tikosyn (black box warning). His 5th day he stopped breathing on me at home. I got him breathing again before the ambulance arrived. This all happened within 25 minutes of taking this drug that morning. I told everyone in the ER who looked at him that he had a reaction to his meds, to please call in a chemist or pharmacist. The lazy cardiologist on call (it was a Saturday) said “ho hum, keep him overnight for observation … and … continue meds. You guessed it! He was given Tikosyn at 9pm that night. By 10pm he was unconscious and had a very determined intern jumping up and down on his chest who managed to save his life. The intern told me I would never have saved him from that one had he been at home. Skip forward 13 years… taking no meds, only herbs and feeling great! Of course my husband’s cardiologist won’t even listen to his heart when he goes in because my husband is not taking the 6-7 chemicals. We believe he contracted a virus almost a year ago that went to his weaker than normal heart. Four days in the hospital and new bucket full of prescriptions. One of which was PRADAXA. Found out during the first month on PRADAXA that it has (black box warning). Did not take PRADAXA the 2nd
month and started weaning himself off of the meds and back to his herbs. It has been 9 months since hospitalization. He feels great! Saw a new Cardiologist just last week who checked him out who knows he is not taking any meds. He was shocked at how well he is doing and said to “continue what he is doing”. Death by modern (allopathic) Medicine causes 784,000 deaths per year in this country. That figure includes; drug reactions, wrong drug prescribed, wrong drug given at hospital, hospital induced infections, elective surgeries … and it goes on. Dr. B … You just do not know how valuable you are to those of us who have eyes to see, and ears to hear.
Hello Dr. Brownstein, along with this blood pressure dialog, I’m curious the extent to which the body relies on cholesterol. Just as they try to frighten us with blood pressure, we see it just as much when it comes to this particular vital substance.
The pattern is recognizable. Whatever the body needs, they want us to avoid. That which we need to stay away from, they try to shovel down our throats. I’m curious your take on this magical essence of the body and product of the liver.
Thank you!
Thank you for your excellent post Dr. B. I’ve referred to your excellent posts about Hypothyroidism (my issue) and have been able to maintain my levels with NatureThroid.
My husband had open heart surgery last year (at age 61) and is doing very well. His doctor wants him to take statins because he has familial hypercholesterolemia, everyone in his family have high cholesterol numbers, including his 92 year old father. After my husband was on statins for only a couple of weeks, he began to experience the typical side effects. We did our research and determined he did not need to take them. The entire study is flawed, biased and funded by the pharmaceutical industry. Keeping our diet pure and organic, with supplements and exercise has been the focus. His last blood test showed his numbers were 380.
He also has been on blood pressure medication to control his numbers: in the 140/100 (approximately) and higher range. I was interested in your opinion about high blood pressure in a heart patient? I did see in your reply to an above comment that “Blood pressure medications can be useful for other conditions such as congestive heart failure and kidney disease. In the right case, blood pressure control is essential” which indicates to me that you tend to feel it’s best for a heart patient to stay on the meds for blood pressure? Is it not possible for him to lower his BP naturally with herbal and vitamin supplements, as well as exercise and stress control? He already has to take asthma meds, which we believe may have contributed to his heart disease since he’s had to take them since he was in his 20’s and they contain steroids.
Thank you and have a Happy New Year!
I had metabolic syndrome. Type 2 diabetes, high BP (160/105). Went ketogenic, and started dropping weight immediately, sugar started coming down dramatically. But my BP was not coming down in the first weeks. Doctor put me on lisinopril, and whether it was that, or one of my diabetes supplements (suspects include Astragalus, and Gymnema), my BP shot up to 180 over 115. Doc added hydrochlorothiazide, which didn’t really help, and now I felt awful all the time. After less than a week, I went back and demanded a change. I stopped all my supplements, and switched from those BP drugs to Bystolic, which is expensive and insurance doesn’t cover it, but I split the pills and lower the overall cost that way. Over the next month, BP came down to 130 over 85, and I’m not trying to get it any lower through drugs. Still on the ketogenic diet (including extensive exercise, which I had to stop that week that it spiked), and sugar is almost normal, if not quite there, yet. As BP drops, I look forward to stopping all drugs to treat it. Even Bystolic, good drug though I think it is, bluntsthe normal adrenergic response, so when I exercise, it’s a chore to get my heart rate up. Once up, it can stay there a long time, but it’s not quite the same as being healthy.
The accurate information you provide on your website and in your books has been a godsend to me for years! In addition to the benefits I utilize in my own health program, I share the information/website with others at every opportunity . As you said, some doctors have not been aware of the natural approach instead of the drug therapies. I have found my doctors to be receptive & grateful when I offer copies of your blogs/books for their consideration. May THE GREAT PHYSICIAN continue to bless you & yours!!!
Thank you for all of the information you share and all of the work you do to find it. I suffered kidney failure from familial FSGS and received my Dad’s kidney. The high blood pressure issue is one of, which caused what: the blood pressure worsened the kidney disease or the kidney disease worsened the high blood pressure.I was on chemotherapy drugs and extremely high doses of prednisone, along with many others to deal with all of the side effects from those, for a year and have suffered greatly. My kidneys went down fast during all of that. I am currently on 200 mg. of Metoprolol daily and feel like that now that the medicine regulates my blood pressure, if I try to get off, I may do damage to my donated kidney. I currently also take 5 mg. of prednisone a day, which I am told will have to for the rest of my life along with the anti-rejection medicine. I run what they consider to be high cholesterol, but refuse statin drugs every time I have a checkup, along with all of the vaccinations they want to give me. I say to them that I thought people who are immunocompromised aren’t supposed to get vaccinations or immunizations and now, those are the very people being targeted.
I just tend to believe I’m one that normally runs a higher blood pressure and it wouldn’t actually affect my health. Could that be the case?
Lisa,
Blood pressure medications have saved many lives. The SPRINT study was done in order to promote blood pressure medications for everybody. They used a miniscule improvement and magnified the results in order to proclaim that we all need to take antihypertensive medications forever.
Having said that, there are many patients who depend on blood pressure medications to prevent them from having a stroke. Blood pressure medications can be useful for other conditions such as congestive heart failure and kidney disease. In the right case, blood pressure control is essential.
To suggest a healthy person needs blood pressure medications for the rest of their life is pure folly. That is how SPRINT was interpreted by the media.
DrB
Thank you so much for having the courage to speak the truth. I’d much rather eat healthy, exercise and tend to stress to take care of my BP issues. So many researchers are looking at a small part instead of the whole picture and then basing their findings on only part of the truth. Would love to see research done in a totally unbiased fashion.
Thank you so much Dr. Brownstein for giving a clear, concise summary of the blood pressure issue. I’m in my mid 60s, non-insulin dependent T2D with good hbA1c and glucose, hypoT on small amount of NDT BUT being pressed hard to take BP meds for slightly elevated 130s/70-80s readings. I’m so glad to have to additional info to confirm taking BP meds not worth the side effects. Your writings and books have helped me so much in dealing with my numerous hormonal imbalances. I only wish I had know these things before BC and HRT, fibroids, endometriosis, etc. and suffering PMS and infertility. Some unrefined salt, Vit. D3, iodine and a little bio ID progesterone may have been all I really needed, Continue success to you. Thanks again.
At the age of 50 my blood pressure without meds was 175/130 and my resting pulse was 85. Today at 66 my blood pressure without meds (and I mean ZERO meds of ANY kind, not even baby aspirin) is 110/65 and my resting pulse is 65. All I needed to do was quit drinking alcohol and clean up my diet to something like a cross between Paleo and Mediterranean, including no refined carbs or processed vegetable oils and relatively high in healthy fats like butter from grass fed cows, avocados and coconut oil. This is very different from what my Big-Pharma-bought ex-cardiologist recommended as a “heart-healthy” diet combined with all the health-destroying artificial chemicals he called “medications.”
Greg,
YOU GO!
DrB
Hello Greg
I am interested in exactly what you did to reduce bp .. it seems now if you go to dentists and bp is high they won’t see you…can you please email
Me ?? I know the time here is a bit dated but thanks for the info!!
Nice analysis. Can you give recommendations on OTC, or herbal, alternative tx for HTN? Thanks.
Thank you for sharing your analysis. I had read about the study and related it to my own blood pressure that runs in the 120-130 range over 70’s. I have noticed that it has increased as I’ve gotten older. Your explanation of the study and what normal blood pressure looks like is very helpful. I really appreciate your posts.
Ruth Ann,
Thanks for the comment.
DrB
Thanks again, Dr B for another great insight. And thanks for putting me on the path to great health! Happy holidays to you and your family!!
It is my honor to see you, Dennis.
DrB
You failed to mention, the control group took an average of 1.8 medications, the Treatment Group had to take 2.8 medications. So an extra Rx pill to decrease your risk by 1.6%, who do you think benefits the most here?
Add on a statin to get the additional benefit of decreasing your risk of dying from a heart attack by 1.8%!
Dr. Jason,
You are being overly generous, in this holiday season, with your statin comment. That is from the most favorable statin studies. Most statin studies show about a 1% benefit.
DrB
Please keep posting about the fraud that is relative risk, which is so misleading.
The other thing about these international studies is that they invariably fail to include groups who are prescribed alternative therapies, such as dietary changes or increased exercise. Maybe being on no drug is the less risk of all.
I noticed that this study did not have a antihypertensive-free control group so who knows whether that is true!!
Dr. S,
You are so right!! This study was so ridiculous that I am thinking about writing a whole newsletter about it.
Big Pharma does not want to compare too many drugs to a healthy alternative regimen because the end result may not be in their favor. The same holds for a placebo.
DrB
After many unpleasant and three nearly fatal (requiring hospital stays) bad reactions to prescription medications, I swore off doctors and turned to herbal treatment of my health problems . Although I have had many allergic reactions to pharmaceuticals……..so far I have not had any reactions to natural products. In twenty + years of using herbs, all have worked just as described. The results? I am 73 and still active and busy. I have goats, chickens and dogs to care for. I have all ready out-lived both my parents. My husband died 4 years ago at age 82, almost 10 years older than any of his male relatives. He was very active but I noticed that he was slowing down. What I didn’t see was how much he was still doing–I found that out when there was only me to do his chores. You know what? You can make new muscle even if you are an old broad like me!! YEH. and AMEN.
Your words have helped me to see that not ALL the medical profession is greedy, heartless, monsters who will do any thing for a buck………..there are still some who have conscience and morality. Look both ways before crossing the street………..we need you.
Gail,
I love your story.
Keep in mind that most doctors want to help. Unfortunately, many do not know a better way as they have only been trained on drug therapies and have no practical or useful knowledge of using natural agents.
DrB
After several weeks using the BEMER electro magnetic field blanket, my wife Linda wrote “Only had it 3 weeks (8 min sessions 2x day). My prior bp has been 140 -202 constantly while taking 100 mg 2x day of lopressor, 1 losartin, and 1 cozaar each day. I am now taking 25 mg lopressor 2x day plus occasional losartin. I really think it’s helping my energy level etc. too.”
EDTA IV chelation or Serrapeptase may help unclog blood vessels. Vit D3 with Vit K2 may keep Ca going into bones more than blood vessels. I have low blood pressure. My adrenals are burned out. Adrenal herbals and cortisol got my blood pressure back to normal and it felt like a miracle. No gluten/dairy/soy/sugar/GMO…vitamins/good oils/minerals…probiotic…LDN..detoxing helps me and Amour thyroid. Celiac may cause heart issues. Low thyroid may cause the heart to not have energy to beat. Hawthorn/garlic/Mg/Zinc may help. Fish oil may thin blood. Vit C may help blood vessels and adrenals. Drugs may hurt like diuretics…lower K and more. Osteoprocare (Ca/Mg)/coenzyme Q10 may help. Statin drugs may lower Coenyzme Q10 the spark plug for cell mitocondria. People may get natural help and thrive.
Doc, When will they wake up and do their job as promised – “Do no harm”.
You have made it extremely difficult for me to accept other doctor’s advise since I now realize so many of them are just following a rule book rather than actually THINKING about what would be best for me as their patient.
You have given me the knowledge to listen critically to my doctors recommendations.
I only wish I had found you about 35 years ago when the prescription madness began.
Unfortunately the desire for money and the inability to admit “I was wrong” will not stop soon.
Thank you for all you do!
Some day, hopefully, you will receive the credit you deserve.
I agree with Denis White completely who asks that you take care of yourself and your family.
Thanks again, T Harris
Dear Dr. Brownstein: I am one of the participants in the SPRINT study – and I agree with you. I have what they call “white coat hypertension”. Have been on BP meds for over 20 years. As a result of the “sulfa water pills” I developed an auto immune disorder of lichen planus. I stopped them on my own and the symptoms are fading. I’ve had every difficult side effect from trying over 13 drugs. I finally tossed them all, and went to Mediterranian diet and some exercise and feel great. Quality of life matters too.
Thanks for being a great voice of reason.
Sincerely,
Patty
Pat,
Thank goodness you survived SPRINT!
For optimizing your health, there is nothing better than cleaning up one’s diet and exercising.
DrB
Dear David,
You are truly a beacon of light in our truly medically misguided world!
I sincerely hope that you and your family stay safe as I am concerned that with all your incredibly brave statements and comments you are in danger of becoming a victim of big pharma and their twisted profit – guided agenda!
I do not say this to worry you but I have seen so many examples of human’ beacons’ like yourself who have suffered greatly for their cause of truth and the pursuit of medical honesty.
Please take care as we really need gutsy pioneers like yourself to help us lay-people to improve our lives.
I wish you and your family a very Merry Christmas and a Happy New Year!
Best wishes
Denis White
( from Guernsey, Channel Islands, UK )
Some 20 years the VA told me I had “high blood pressure” and prescribed a medication to lower it. I’m a big believer in addressing health issues without drugs whenever possible, so I changed my diet and lifestyle. Now, my blood pressure is often as low as 61/47. It’s virtually never over 95/65 – usually much lower. Yet my doctors at the VA feel I should STILL take 24 mg of Metoprolol daily (although they did agree to lower it from 48mg daily). I keep asking if my BP isn’t getting too low, but they all seem to think that “lower is always better” – unless I start fainting a lot. (I don’t.) Am I a freak? Should I be grateful for having such low BP? I’m confused.
Will,
Lower is not necessarily better for everyone. However, I have many patients with very low blood pressures who are in great health. An optimal blood pressure is unique for each patient. I assure you that I do not recommend blood pressure meds to my healthy patients with low blood pressure.
People with naturally low blood pressure can be healthy. However, chemically dropping blood pressure to your low levels usually is not a good thing.
DrB
DrB
Another thing: I’m always suspicious when studies like this are stopped early. This practice cases severe bias in favor of positive findings for interventions.
A short term or spurious or otherwise misleading “positive” finding —> study stops and is never repeated because Truth has been established and it is now “unethical” to try to replicate the findings (as is always done in real science). However, negative findings never lead to early termination, so there’s plenty of time for short term or spurious or otherwise misleading negative findings to turn around.
Also, this study wasn’t double blinded. The investigators obviously knew which patients got which protocol. Another very real possible source of all kinds of bias.
Interesting study, but does not to me establish any kind of Truth. Plus, most people can lower their BP if they want to with low carb/paleo style diets and high intensity resistance exercise. In that case, BP may not even rise with age, just as seen in cultures eating their traditional diets. My BP in my mid 50’s is the same as it was in my 20’s. I’ll repost my BP here in 20 or 30 years and we’ll see how that worked out :-).
Nice one doc– more commonsense by yourself carry on !
I love it. Fugetaboutit. Capisce? Keep up the phenomenal work. Not only are you saving lives, but giving people a better quality of life while they’re here. God bless you.
Susie Lee,
Capisce.
DrB