New Blood Pressure Recommendations Confuse Patients, Doctors
One of the major health concerns for diabetics is blood pressure; one of the more dangerous side-effects of diabetes is high blood pressure, thanks to the way blood glucose levels affect the cardiovascular system. Diabetics of all ages and particularly those over the age of 60 have good reason for listening to their doctors’ instructions on controlling and maintaining proper blood pressure—and just as diabetics buy Contour strips, or pump supplies, insulin pen needles or Easytouch insulin syringes, many also spend money on blood pressure medications to protect themselves from the risk of heart attack and stroke. However, recent guidelines published in the Journal of the American Medical Association by the Eighth Joint National Committee have brought about a discussion of just how under control blood pressure really must be—and how effective medications are at controlling it.
The guidelines represent a substantial change to the current recommendations for all adults to get their systolic blood pressure underneath 140; two major medical professional societies, the American Heart Association and the American College of Cardiology, endorse that guideline. However, the Joint National Committee’s guidelines say that many people over 60 do not need to start taking medications to lower blood pressure until it is more than 150/90. The new guidelines do specify that for adults under 60, the goal remains at 140; it does, however, wipe out the lower target of 130 for individuals with diabetes or kidney disease. In many cases, diabetics were buying blood pressure medicines at the advice of their doctors right alongside products such as pump supplies, insulin pen needles, and other diabetes supplies like Easytouch insulin syringes and Contour strips. Under the new guidelines, medical providers—if they follow them—will be much less likely to prescribe medication to people with a milder risk of heart problems.
The reasoning explained for this change is that the medications themselves lack conclusive evidence on important metrics: namely, there is less than hearty evidence that using drugs to get lower blood pressures reduces a person’s risk of heart attack or stroke, or that they increase life expectancy. The evidence-based approach is being lauded by much of the medical community, although many doctors are confused by the fact that there are competing guidelines coming out as the National Institutes of Health has decided that it will no longer publish criteria—leaving it to professional societies. Dr. Harlan Krumholz, a cardiologist at the Yale School of Medicine, says of the news, “We should be going after people with marked elevation to make sure they’re all getting treated. People with mild risk, you have to be honest with them, and say ‘I don’t know if I’m doing much for you.’” While diabetes is often a very expensive illness to treat, even when patients can find deals on Easytouch insulin syringes, or Contour strips, pump supplies, or insulin pen needles, it’s possible that the decrease in prescriptions for blood pressure medicines will not only help diabetics avoid side effects from medicines that don’t provide the greatest benefit, but also help them avoid spending money that can be dedicated to other needs.
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