Give Blood Pressure Drugs to All - page 2

by Jolie 5,803 Views | 47 Comments

From Medscape CME: May 28, 2009 — Blood-pressure-lowering drugs should be offered to everyone, regardless of their blood pressure level, as a safeguard against coronary heart disease and stroke, researchers who conducted a... Read More


  1. 1
    My 75 yr old mother tends to have low BP. Why would I give her many of the BP meds out there?
    herring_RN likes this.
  2. 3
    My resting BP can be as low as 98/56. Trying to imagine me on lopressor.......
    4hana9, herring_RN, and VICEDRN like this.
  3. 2
    Quote from fairycari
    if people would get off their butts and try to control their blood pressure with diet and exercise first and their physicians actually spent the time to explain to them that this would actually work if they *actually* did it.

    i am 5'6, 128 pounds. i do not eat candy, chips, cookies, pasta or any processed foods. i eat fish at least 4 times a week. salt has never been a part of my diet, i am a 'health nut'.

    i do 1 full hour of cardio on the elliptical at the gym 6 days a week, and do weight training for another 45minutes to an hour 3-4 days a week.

    boy was i shocked when my bp was 190/110.

    that was back in 2007, and i have had the same good diet and exercise pattern for years.

    you do not have to be overweight and inactive to have hbp, it can be caused by genetic predisposition.

    i take bp meds.

    i certainly agree. i apologize that i overgeneralized. i worked with someone who ran four times a week, never smoked, eat crazy healthy and had hypertension anyway. he also had a genetic predisposition. my stepmother is much the same way, eating a tablespoon of cinnamon a day with no measurable difference in her bp.

    again, i am sorry that i left my qualifier out. no offense intended. i am aware that not everyone is lucky enough to escape hypertension regardless of what they do. i intended to qualify with the word first in my original post, "....with diet and exercise first..."
    Last edit by VICEDRN on Jun 4, '09
    herring_RN and Teresag_CNS like this.
  4. 2
    My resting HR is usually in the high 50s/low 60s but my SBP is consistently in the 130s (sometimes 140s). I'm 5/6" 150 lbs.

    It doesn't make sense - but I do know I could stand to eat a little healthier (avoid all that salt and processed foods. I don't eat chocolate/candy/pie/ice cream/cake etc. anyway... haven't had any in almost 8 years ) and maybe exercise a little more...


    cheers,
    herring_RN and VICEDRN like this.
  5. 1
    That's insane. My bp usually runs about 90/60, sometimes much lower. Should I get on board with this?
    herring_RN likes this.
  6. 1
    actually I just got a "read and sign" that said anybody going to surgery, no matter what age, race, or creek, MUST be given and prescribed a beta blocker prior to OR. ... UNLESS there is a medical reason to not. They further said that this will be soon a "do it or don't get paid" type of situation whereas if you don't give or get the b-blocker for the pt, and something goes awry, the insurance will have the right (or medicaid) to not pay for it.
    wooh likes this.
  7. 4
    Quote from shiccy
    actually I just got a "read and sign" that said anybody going to surgery, no matter what age, race, or creek, MUST be given and prescribed a beta blocker prior to OR. ... UNLESS there is a medical reason to not. They further said that this will be soon a "do it or don't get paid" type of situation whereas if you don't give or get the b-blocker for the pt, and something goes awry, the insurance will have the right (or medicaid) to not pay for it.
    Then your hospital is jumping on a bandwagon that may already falling apart. Beta blockers for all surgical patients isn't necessarily a good thing. I follow the Hospitalist's blog and he addresses this in this post:

    http://community.the-hospitalist.org...ers-redux.aspx

    ...it's a blog, I know, but it makes some pretty good arguments about these kind of studies including links to journals analyzing these.

    Tight glycemic control is another one of those things that was not adequately studied prior to large-scale implementation, and as a result may be doing more harm than good.
  8. 0
    That's actually very interesting ..... the read and sign that I read said that *any* b-blocker in *any* dose can be used...

    I personally didn't think that it was a good thing, but who am I to say that?
  9. 2
    Did anyone else do the whole unit? The study was from the UK. Doctors in America were generally unimpressed with it. I liked this doc's take on it.
    Adding his opinion, Dr Franz Messerli (St Luke’s-Roosevelt Hospital Center, New York City) said that by including 147 trials in their meta-analysis, the authors had to make numerous assumptions, “some possibly valid, others clearly not.”
    Because the “blood pressure fall was not reported in patients with a history of coronary heart disease, they estimated this fall from a meta-analysis of blood pressure trials. This is clearly inappropriate since the fall in blood pressure depends on the pretreatment level, and patients with coronary heart disease who often are hypotensive (particularly post MI) will not respond the same way as do patients with hypertension,” he told heartwire.
    It is little surprise that beta blockers now, all of a sudden, look better than in any other review ever done, Messerli added. “Numerous meta-analyses have clearly demonstrated that beta blockers do not reduce the risk of coronary heart disease in hypertension, despite the fact that they lower blood pressure. Thus, despite its appearance of being bigger and better, this study is yet another example of my dictum: A meta-analysis is like a sausage, only God and the butcher know what goes in it and neither would ever eat any.”
    ImMrBill3, RN and GilaRRT like this.
  10. 5
    Quote from Jolie
    From Medscape CME:

    May 28, 2009 — Blood-pressure-lowering drugs should be offered to everyone, regardless of their blood pressure level, as a safeguard against coronary heart disease and stroke, researchers who conducted a meta-analysis of 147 randomized trials (comprising 958,000 people) conclude in the May 19 issue of BMJ [1].

    “Guidelines on the use of blood-pressure-lowering drugs can be simplified so that drugs are offered to people with all levels of blood pressure,” write Drs Malcolm R Law and Nicholas Wald (Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine, Queen Mary University of London, UK). “Our results indicate the importance of lowering blood pressure in everyone over a certain age, rather than measuring it in everyone and treating it in some.”

    full piece: http://cme.medscape.com/viewarticle/703463?src=cmenews

    Is it just me, or does this sound like yet another "study" funded by a drug company?

    I have an idea: how about communicating with people and paying for their medications so that they can adhere to therapy? How about a thorough assessment of side effects? How about a caring relationship that will allow patients to disclose embarrassing problems like impotence (ED)? Those measures would go a longer way toward reducing the morbidity of hypertension. Giving everyone medication is a very bad idea for a multitude of reasons.
    RN BSN 2009, VivaLasViejas, VICEDRN, and 2 others like this.


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