Hypertension contention

Blood Pressure: Low equals "slow"

Last August (Daily Dose, 8/8/2003), I wrote an article lambasting
the American Medical Association for lowering its guidelines for
healthy blood pressure for the umpteenth time. To recap, their
latest recommendations cite anything over 115/70 (!) as being
"high." Just 6 years ago, that number was 140/90 (still plenty low).
If their guidelines get much lower, any detectable pulse will
qualify as "high risk" in their eyes...

Aside from the fact that there's no evidence that high blood
pressure causes heart disease (it's often a response to the condition,
but not its cause), and the fact that salt intake is only remotely
correlated to hypertension, there's one more widespread myth
about blood pressure that most people — and their doctors —
don't seem to know about:

Your blood pressure can be TOO LOW (115/75 is borderline, if
you ask me).

And now, some research from Israel shows just how big of an
impact low blood pressure can have on health — especially upon
those who are getting up in years. According to a recent Reuters
online article, a Ben Gurion University study showed that patients
over 70 with what modern standards call "mild hypertension"
actually thought more clearly and creatively than those with lower
blood pressure.

Both men and women in the nearly 500-subject study whose blood
pressure was deemed high enough to warrant treatment with
prescription drugs — and also those with clinically uncontrolled
(untreated) hypertension — performed significantly better on tests
of cognitive function, memory, concentration, and visual retention.
Only in tests of verbal fluency was there no meaningful scoring
advantage for the high-BP group...

Those with "normal" blood pressure tested the worst of all three
groups in the study.

Similar studies in younger test populations yielded no difference in
performance based on blood pressure. What's this mean? It means
that physicians need to balance their efforts to control what they
perceive as risk factors for heart disease (namely, BP over 115/75)
with patients' quality-of-life concerns — like mental sharpness and
creativity.

In other words, they should stop meddling with the body and mind
and let it find its own equilibrium. But the over-medication of
senior citizens isn't just limited to the treatment of hypertension.
Keep reading...

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Drug-induced emergencies twice as common as left-handedness

I've long lamented the needless over-prescription of all kinds of
drugs to American senior citizens — and with the pharmaceuticals
industry's merciless marketing of their poisons to aging baby
boomers, there's no end to the trend in sight.

But is drug-company targeting of conditions likely to be suffered
by seniors actually causing more illness than it helps to cure? I
think so. But a recent study shows just how prevalent drug-induced
medical problems really are. According to the research, fully 20%
of all emergency department visits are senior citizens suffering
drug-related side effects or interactions.

That means you're twice as likely to end up in the ED because of
your medications as you are to be left-handed!

Why is this happening? Often, it's because physicians don't know
enough about how the ever-growing array of drugs interact with
one another, so they prescribe them in error. This is especially
prevalent in cases where patients have more than one doctor (a
very common occurrence nowadays).

Also, the complexity of adhering to medication schedules can
contribute to confusion over dosages or accidental overdoses —
especially in the case of elderly patients with multiple medications
(also quite frequent in this day and age). One 2002 study identified
2.2 million cases of seniors taking more than the recommended
dosages of their medications.

The solution to this over-medication of the elderly is three-fold:
First, fewer doctors treating each patient (and better
communication between them if there must be more than one).
Second, better education of doctors about drug interactions and
side effects. And third...

FEWER DRUGS BEING PRESCRIBED!

What are the odds of all these things happening? A lot slimmer
than the 1 in 5 chance the average senior has of ending up in the
ED because of problems with their drugs.

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