Dear Dr. Rick,
I heard on your radio show that there were new “guidelines” for blood pressure and cholesterol. Can you tell me more about that?
Yes, there are new guidelines for both.
There are national medical organizations that regularly review the latest scientific data on high blood pressure and cholesterol and make recommendations on how these should be treated. They do this because high blood pressure and abnormal cholesterol are factors that greatly increase your risk for diabetes, heart attacks and strokes. By using exercise, healthy food choices and medicines, these conditions, for the most part, can be prevented.
The Eighth Joint National Committee recently released their suggestions for blood pressure goals in adults 60 years and older and moved them from target levels of 140/90 or lower to 150/90 or lower. Target blood pressures for younger individuals were moved from 120/80 or lower to 130/80 or lower. (http://jama.jamanetwork.com/article.aspx?articleid=1791497)
Under these guidelines, the number of adults requiring blood pressure medications would fall from about 41% to 32%. With these new guidelines, about 28 million U.S. adults would still have uncontrolled high blood pressure, half of whom were receiving no treatment.
These guidelines are designed to protect patients from over-treatment which could result in too low a blood pressure, dizziness, falls and other side effects. Further research will be necessary to support these recommendations, but they are based on the best available evidence.
The American College of Cardiology and American Heart Association Guideline for cholesterol was released in 2013 and changed recommendations there as well. (http://circ.ahajournals.org/content/early/2013/11/11/01.cir.0000437738.63853.7a) Previously, there had been strict recommendations for starting folks on statin medications, like pravastatin, if exercise and diet did not get their LDL (bad cholesterol) lower than 120. The new guidelines allow the treatment of LDL cholesterol with statins when cholesterol values are already lower than 120 in individuals at high risk for heart disease. This includes folks with diabetes and those with family histories of heart disease or other risk factors, like smoking. Scientific data continue to demonstrate that statins have a number of protective effects against heart and blood vessel disease, beyond simply decreasing bad cholesterol levels or, less so, increasing good cholesterol levels (HDL).
The bottom line is, you still need to know your numbers (see box). Studies from the Korean War and the Bogalusa Heart Study in Louisiana show that the abnormalities in blood vessels associated with cardiovascular disease frequently begin in childhood. Most pediatricians are now checking children for blood pressure, blood sugar, and cholesterol abnormalities. I recommend you insist on this if your child is overweight or obese. I will give some pointers on how to figure that out in an upcoming article.
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Dr. Rick deShazo, professor of medicine and pediatrics at the University of Mississippi Medical Center and a practicing physician, is the host of Southern Remedy. The medical information presented by Southern Remedy is meant to provide general information about the topics discussed, and should not be used or relied on for any diagnostic or treatment purposes. The information conveyed does not create any type of patient-physician relationship and should not be used as a substitute for professional diagnosis and treatment. Please consult your health care provider before making any healthcare decisions and for guidance about your specific medical condition.