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Blood pressure values Should hypertensives be used across the board?
Hypertension is dangerous, as it permanently overloads the heart and blood vessels and, if left untreated, can cause a heart attack or stroke. The treatment is therefore primarily about lowering blood pressure. According to a recent US study using drugs should be aimed at a value of less than 120 mmHg.
Doctors call for early use of antihypertensives. Image: psdesign1 - fotolia Almost half of the over 50s are affected
30% of Germans have high blood pressure (hypertension) according to the German Hypertension League (EHV), and over 50% even have their blood pressure up to 50%. A not to be underestimated danger, because over the years important organs such as e.g. Heart, brain and kidneys damaged, which can lead to life-threatening diseases such as heart attack or stroke.
Therefore, the main goal in the treatment of hypertension is to permanently lower blood pressure to a normal level. Although this can be achieved in some cases by a lot of sports and healthy nutrition, but often drugs are needed. The question of how high the hypertension is to be lowered, has been answered so far usually with 140. But now, a large US study has found that sufferers can greatly benefit from a health benefit if the value of systolic blood pressure is instead set at 120 mmHg (millimeters of mercury).
Hypertension can have life-threatening consequences
The result of the so-called "SPRINT" study has now been presented at the conference of the US Heart Association and in the journal "New England Journal of Medicine". The US Department of Health had already announced in September that the investigation had ended prematurely, as there were nearly one-third fewer infarctions and strokes and nearly a quarter fewer deaths in the intensively treated group.
Now the concrete data is available. Thus, infarct, stroke, heart failure, cardiovascular death, or other causes were reported to be less common in the group whose blood pressure was below 120. However, acute renal failure, circulatory collapse, a threateningly slow heartbeat and a dangerous imbalance in the electrolyte balance were more common in the more intensively treated group.
The head of the Hypertension Center Munich, Prof. Martin Middeke, assessed the current meta-analysis rather skeptically. "You can not shuffle everything. The treatment of blood pressure is always an individual therapy. "It must always be considered the pre-existing conditions. Medicines that lower blood pressure can also lead to severe kidney damage, said the renowned cardiologist.
It does not always have to be medication
Paulus Kirchhof, a cardiologist at the University of Birmingham, explained, "Spiegel Online": "Sprint has addressed a question that has been bothering cardiologists for years: how much should one lower blood pressure?" This is true of the big and good study done now not for everyone, but answered for many patients. It showed: "The number of serious cardiovascular events and deaths is reduced. However, you have to take a higher risk of serious side effects. "
However, the new findings do not mean that all with a blood pressure above 120 now need to see the doctor, but easy high blood pressure must also be treated, experts advise. In some cases home remedies for high blood pressure are enough to get the problem under control. These include, for example, Kneipp's applications such as an ascending armband, as well as certain medicinal herbs (such as hawthorns, lemon balm leaves) or essential oils (e.g., lavender, marjoram) may help lower blood pressure somewhat.
However, the most important and most effective remedy for excessive blood pressure, according to the German Hypertension League e.V., is a healthy lifestyle, as it can often reduce mild hypertension to a normal level. Accordingly, it is especially advised to reduce obesity and to ensure a healthy diet with little salt and a moderate alcohol consumption. In addition, sufferers should absolutely give up smoking and move regularly, but at the same time it is important to have a regular daily routine with breaks in order to be able to recover and relax.
Study with hypertension patients
The new study will only target people with an already increased risk of cardiovascular disease. "The group studied in Sprint is one that is already being treated by the cardiologist - or should be," Kirchhof said. "The result should not lead to more people being treated - but to some patients being treated more intensively." Overall, the researchers studied 9,361 individuals from the US and Costa Rica. All participants were older than 50 years and had a blood pressure of 130 to 180, in addition to other risk factors for cardiovascular disease such. Overweight. On the other hand, patients with diabetes mellitus or a previously suffered stroke were excluded from the study, the scientists report in the New England Journal of Medicine..
"Despite the side effects, fewer people died"
A total of 155 people (3.3 percent) from the intensively treated group died. In the control group with standard therapy, there were 210 persons (4.5 percent). Among them were 37 deaths from cardiovascular diseases in the intensive care group and 65 among the control subjects. The cases of acute renal failure were also striking: 204 (4.4%) of the intensively treated patients were affected and 120 (2.6%) were in the control group.
"Despite the side effects, fewer people died in the intensively treated group," explained Kirchhof. The subjects had to take on average 2.8 different antihypertensives, so in the group a mean blood pressure of 121 was reached, but "that patients take three or five different drugs simultaneously, is not unusual in cardiology," said Kirchhof. "I strongly believe that the sprint result will feed into the next guideline. And I can imagine that a blood pressure of 120 is recommended as a treatment target for the group under investigation, "said the physician, who has worked on the current European guideline on hypertension therapy. (sb, no)