High drug doses 'may not benefit 150,000 patients'

Up to 150,000 Irish patients treated for high blood pressure may not benefit from increases in their medications or higher dosages, according to new research.

High blood pressure increases the risk of stroke, heart attack, kidney failure and congestive heart failure.

The higher level of treatment would have been recommended for these patients following recent updated guidelines.

These guidelines from the US, which were adopted in Europe, lowered the threshold for measuring blood pressure, according to the study by NUI Galway.

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The diastolic blood pressure threshold of 80 was a reduction from previous guidelines that advised doctors to use 90 or more. Diastolic blood pressure is the lower of two readings reported when describing blood pressure readings.

These high blood pressure guidelines are observed widely in Ireland. As a result, as many as 150,000 patients with a bottom blood pressure number of over 80 may need more treatment to get their diastolic number down.

Overtreatment

But patients with a normal top blood pressure number below 130 are potentially at risk of being overtreated, according to the findings from the National Institute for Prevention and Cardiovascular Health.

The new study, published in the ‘Journal of the American Medical Association’, means patients with these readings can be spared increasing their medications or dosages.

Prof Bill McEvoy, who led the study, said: “There is little doubt treating the systolic or top blood pressure value down to 130 is beneficial and reduces heart disease and stroke.

“This is important to stress. However, the recommendation to also treat the diastolic or lower value down to 80 is more controversial and our results would suggest that the more traditional target for diastolic blood pressure of 90 is also safe as long as the top number is controlled below 130.

“By focusing on good control of the top number and by relaxing drug treatment goals for adults with isolated increases in the bottom diastolic blood pressure number, we may be able to avoid potential overtreatment of a lot of people and instead focus on healthy diet and lifestyle.”

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