steve@hito.com wrote:

Current guidelines are to treat to goal of 115/75 or less.

Risks associated with untreated BP of 125/80 would be increased risk of
developing problems attributed to hypertension.

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
http://www.heartmdphd.com

Sun, 02 Nov 2003 19:11:32 GMT in article
<49720baefbe4ae88f0da4ff573c39f42@news.teranews.co m> "Dr. Andrew B.
Chung, MD/PhD" <andrew@heartmdphd.com> wrote:

this study:

Merlo J, Ranstam J, Liedholm H, Hedblad B, Lindberg G, Lindblad U,
Isacsson SO, Melander A, Rastam L. Related Articles, Links
Incidence of myocardial infarction in elderly men being treated with
antihypertensive drugs: population based cohort study.
BMJ. 1996 Aug 24;313(7055):457-61.
PMID: 8776312 [PubMed - indexed for MEDLINE]
<http://bmj.bmjjournals.com/cgi/content/full/313/7055/457>
<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=877631 2&dopt=Abstract>

Abstract:

"OBJECTIVE: To analyse the association between use of
antihypertensive treatment, diastolic blood pressure, and long
term incidence of ischaemic cardiac events in elderly men.
DESIGN: Population based cohort study. Baseline examination in
1982-3 and follow up for up to 10 years. SETTING: Malmo,
Sweden. SUBJECTS: 484 randomly selected men born in 1914 and
living in Malmo during 1982. MAIN OUTCOME MEASURES:
Observational comparisons of incidence rates and rate and
hazard ratios of ischaemic cardiac events (myocardial
infarction or death due to chronic ischaemic cardiac disease).
RESULTS: The crude incidence rate of ischaemic cardiac events
was higher in those subjects who were taking antihypertensive
drugs than in those who were not (rate ratio 2.6 (95%
confidence interval 1.7 to 3.9)). After adjustment for
potential confounders (differences in baseline smoking habits,
blood pressure, time since diagnosis of hypertension, ischaemic
or other cardiovascular disease, hypercholesterolaemia,
hypertriglyceridaemia, diabetes mellitus, obesity, and raised
serum creatinine concentration) this rate was reduced but still
raised (hazard ratio 1.9 (1.0 to 3.7)). In men with diastolic
blood pressure > 90 mm Hg, antihypertensive treatment was
associated with a twofold increase in the incidence of
ischaemic cardiac events (rate ratio 2.0 (1.1 to 3.6)), which
vanished after adjustment for potential confounders (hazard
ratio 1.1 (0.5 to 2.6)). In those subjects with diastolic blood
pressure < or = 90 mm Hg, antihypertensive treatment was
associated with fourfold increase in incidence (rate ratio 3.9
(2.1 to 7.1)), which remained after adjustment for potential
confounders (hazard ratio 3.8 (1.3 to 11.0)). CONCLUSION:
Antihypertensive treatment may increase the risk of myocardial
infarction in elderly men with treated diastolic blood
pressures < or = 90 mm Hg."

--
Matti Narkia

Sun, 02 Nov 2003 20:27:52 GMT in article
<v8paqv0p9e088e36v3fk4l6fuln4h0nuip@4ax.com> Matti Narkia
<mnng@despammed.com> wrote:


MI AND ANTIHYPERTENSIVES: THE J-SHAPED CURVE REVISITED
Journal Watch (General), October 1, 1996; 1996(1001): 2 - 2.
http://general-medicine.jwatch.org/c...ll/1996/1001/2

"MI AND ANTIHYPERTENSIVES: THE J-SHAPED CURVE REVISITED

This Swedish cohort study adds to the growing body of evidence
that it is possible to overtreat hypertension. The study
involved 484 men born in 1914 who were initially examined from
1982 to 1983 and followed for up to 10 years. The outcome of
interest was myocardial infarction or cardiovascular death.

Subjects taking antihypertensive agents were 2.6 times as
likely to have an ischemic cardiac event as those not taking
antihypertensives. After adjustment for confounders (smoking
habits, blood pressure, duration of hypertension, diabetes,
obesity, and elevated serum creatinine level), this relation
weakened, but did not disappear (hazard ratio, 1.9). In men
with diastolic blood pressure higher than 90 mm Hg, the use of
antihypertensives was associated with a two-fold increase in
cardiac risk that disappeared after correction for confounders.
In men with a diastolic blood pressure of 90 mm Hg or lower,
the use of antihypertensives was associated with a 3.9-fold
increase in risk that persisted after adjustment for
confounders.

Comment: While the number of cardiac events was relatively
small, the investigators did a good job of eliminating other
kinds of bias, such as lower blood pressure being a sign of
more severe underlying illness. Thus, these data support a J-
shaped relation between treated blood pressure and cardiac
events in men. In other words, lowering blood pressure below a
certain level increases risk. --KI Marton

Published in Journal Watch October 1, 1996"

--
Matti Narkia

Sun, 02 Nov 2003 20:40:34 GMT in article
<7oqaqvgivq83c08tk4h8476s3rvtnkgegt@4ax.com> Matti Narkia
<mnng@despammed.com> wrote:


1: Cruickshank J.
The J-curve in Hypertension.
Curr Cardiol Rep. 2003 Nov;5(6):441-52.
PMID: 14558984 [PubMed - in process]
<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=145589 84&dopt=Abstract>

2: Cruickshank JM.
Antihypertensive treatment and the J-curve.
Cardiovasc Drugs Ther. 2000 Aug;14(4):373-9. Review.
PMID: 10999643 [PubMed - indexed for MEDLINE]
<http://www.ncbi.nlm.nih.gov/entrez/q...&dopt=Abstract

--
Matti Narkia

"Dr. Andrew B. Chung, MD/PhD" <andrew@heartmdphd.com> wrote in message news:<49720baefbe4ae88f0da4ff573c39f42@news.terane ws.com>...
Is this guideline universally accepted? When or during which hour of
a day should the BP be measured? Early in the morning or late in the
evening. I think there is a diference in using this guideline when
applied to patients with or without inherited HBP. People with HBP
that is of an inherited nature should be expected to assume a higher
number. No? Personally i would feel a bit uncomfortable and tense
when it goes about near 140/90 _before going to bed_ but anything
below 135/85 is just fine.

FP

francispoon writes:

Nothing is ever universally accepted. It is widely accepted.

It matters little, as long as you are quietly at rest and you always
measure it under the same circumstances (with an empty bladder, after
sitting quietly for a time, on the same arm, with arm in the same
position and cuff level with the heart, etc.).

The damage done by hypertension is independent of how it developed, so
the guidelines would be the same for people with or without a given type
of hypertension.

In theory, the higher it is, the sooner it will cause problems. If it
is only very slightly elevated and you are not still a child, you may
die of other causes before the BP causes any problems. Contrary to what
many people seem to wish to believe, there are no sharp cutoff points.

--
Transpose hotmail and mxsmanic in my e-mail address to reach me directly.

francispoon wrote:

Nationally it is. That's why they call it JNC guidelines. *J*oint *N*ational *C*ommittee.

Morning is preferred.

The predisposition for HBP seems to be inherited.

No.

Not sure what your question is.

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
http://www.heartmdphd.com/

see below

"Dr. Andrew B. Chung, MD/PhD" wrote:

B-0b1 here...why not less than 135/75 as in 110 max over about 65 average??
It IS attainable..as I have been in the 180/110+ bracket a good part of my life UNTIL I
learned the RULES about proper eating AND took a regular Vitamin Mineral (balanced)
regimine with all AVERAGES taken into consideration. My OWN products also made it a
certainty. Since 1994/5...I have been where I belong...as in age 63 + I am NOW 71+
and have never been so healthy. I can HELP anyone do the same thing by giving them a
FREE KIT with instructions that take about 2 hrs average week or less. (Total additive)

You may pay the shipping IF you can hack it...otherwise I'll do it.all I need are ADDY"S.
Once you begin to FEEL the "differences" You'll wonder why you didn't do it years ago??
Simplicity is the answer to any complex problem...B-0b1 "Dead Doctors do NOT Lie"

"Dr. Andrew B. Chung, MD/PhD" wrote:

B-Ob1 writes:

Why not 90/50?

Indeed, why allow blood pressure at all? Any non-zero pressure just
puts a strain on the heart and blood vessels.

--
Transpose hotmail and mxsmanic in my e-mail address to reach me directly.

On Sat, 08 Nov 2003 08:01:12 +0100, Mxsmanic <mxsmanic@hotmail.com> wrote:

This is a great point. My blood pressure was 135/80 for as long as I can
remember. My cholesterol in medschool was 150 after eggs and bacon! Last
year it was slightly over 200 fasting with an LDL of 125.

When I performed my own CIMT, however, I was blown out of the water. A
subtle finding of my particular carotid intima-media complex appeared to be
muscular hyperplasia, and the thickness was worrisome.

This is why I now take lisinopril, 40 mg qhs (among other things), and my
blood pressure is 95/60. Yes, I sometimes feel light headed when I stand
quickly, but personally I am willing to put up with the side effects and
hope that it will help reverse the atherosclerosis that has developed. I do
not want to follow the footsteps of my grandfather, whom I never met. He
died of a massive coronary in his early 50's.

--
~~~
Patrick Blanchard, M.D., A.B.F.P.
Board Certified in Family Practice
http://www.familydoctor.org/blanchard

Patrick Blanchard, M.D. writes:

You prefer renal failure instead?

--
Transpose hotmail and mxsmanic in my e-mail address to reach me directly.

"Patrick Blanchard, M.D." wrote:

Thanks for sharing, Patrick.

I've seen folks walking around in the hallways waiting for a heart transplant
(sometimes many months) with blood pressures around 80/40. We know what little
heart muscle they have left is going to last longer with low blood pressure
rather than high.

Humbly,

Andrew

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
http://www.heartmdphd.com

Mxsmanic wrote:

ACE inhibitors are renally protective.

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
http://www.heartmdphd.com

Dr. Andrew B. Chung, MD/PhD writes:

Which organs suffer first when the blood pressure drops too low?

--
Transpose hotmail and mxsmanic in my e-mail address to reach me directly.

Mon, 10 Nov 2003 09:07:37 +0100 in article
<vnhuqvku3mr8k38g45e0k9cs5vbru2knb2@4ax.com> Mxsmanic <mxsmanic@hotmail.com>
wrote:

consists of elderly men:

Merlo J, Ranstam J, Liedholm H, Hedblad B, Lindberg G, Lindblad U,
Isacsson SO, Melander A, Rastam L. Related Articles, Links
Incidence of myocardial infarction in elderly men being treated with
antihypertensive drugs: population based cohort study.
BMJ. 1996 Aug 24;313(7055):457-61.
PMID: 8776312 [PubMed - indexed for MEDLINE]
<http://bmj.bmjjournals.com/cgi/content/full/313/7055/457>
<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=877631 2&dopt=Abstract>

(The above study was commented in Journal Watch as follows:

MI AND ANTIHYPERTENSIVES: THE J-SHAPED CURVE REVISITED
Journal Watch (General), October 1, 1996; 1996(1001): 2 - 2.
<http://general-medicine.jwatch.org/cgi/content/full/1996/1001/2> )

Cruickshank J.
The J-curve in Hypertension.
Curr Cardiol Rep. 2003 Nov;5(6):441-52.
PMID: 14558984 [PubMed - in process]
<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=145589 84&dopt=Abstract>

Cruickshank JM.
Antihypertensive treatment and the J-curve.
Cardiovasc Drugs Ther. 2000 Aug;14(4):373-9. Review.
PMID: 10999643 [PubMed - indexed for MEDLINE]
<http://www.ncbi.nlm.nih.gov/entrez/q...&dopt=Abstract

--
Matti Narkia

"Dr. Andrew B. Chung, MD/PhD" <andrew@heartmdphd.com> wrote in message news:<3ab2a801337a664dd6b8109b637c391f@news.terane ws.com>...
I am new to this group so pardon me if I'm not following protocol. I
have a question about my own blood pressure. My systolic seems to be
normal (122) but my diastolic is a little high (92). What exactly
does this mean. What long-term consequences am I facing if any? What
action (if any) should I take?

Thanks,

Mike

On Sun, 09 Nov 2003 09:47:59 +0100, Mxsmanic <mxsmanic@hotmail.com> wrote:

I am certain you know that atherosclerosis can also lead to renal failure.

--
~~~
Patrick Blanchard, M.D., A.B.F.P.
Board Certified in Family Practice
http://www.familydoctor.org/blanchard

On Mon, 10 Nov 2003 09:07:37 +0100, Mxsmanic <mxsmanic@hotmail.com> wrote:

the brain.


--
~~~
Patrick Blanchard, M.D., A.B.F.P.
Board Certified in Family Practice
http://www.familydoctor.org/blanchard

Michael Brock wrote:

Mike..It means that your heart is really healthy...95 IS a tad high but when it
was taken had you just walked up some stairs or some minor excercise..or had
just eaten something?? Check ir regualrly every 6 hrs for three days and note the
minute differences. If it is still hig, hen there may be a dietary reason. What IS a
"normal" diet for you..do you mix starch and meat as in HAMMY BUGGERS??
.do you take supplements regularly?? It may be a simple answer!
B-0b1

On Mon, 10 Nov 2003 13:14:36 -0600, B-Ob1 <sos@Grandecom.net> wrote:

The blood pressure is not the most relevent for my case, however.
Lisinopril has been shown to reduce carotid intimal thickness over time.

http://tinyurl.com/ufht

Kakinuma Y, Kawamura T, Bills T, Yoshioka T, Ichikawa I, Fogo A.
Blood pressure-independent effect of angiotensin inhibition on vascular
lesions of chronic renal failure.
Kidney Int. 1992 Jul;42(1):46-55.

The ALLHAT study, among others, indicates that there is
sooommmmmmeeeethiiiinnnngggg else occurring rather than blood pressure
reduction when looking at the data of fewer cardiovascular events.

In my opinion, it does not mean, by itself, that your heart is healthy.


--
~~~
Patrick Blanchard, M.D., A.B.F.P.
Board Certified in Family Practice
http://www.familydoctor.org/blanchard