Medicine today is built on a house of cards. We think that if high blood pressure medication lowers our numbers, we’re safe. Not even close to true.
I have covered again and again the fallacy of what is referred to as “surrogate end markers.”
In using surrogate end markers, the idea is that, for Disease X, patients with lower values of Blood marker B live longer or are less likely to get the disease. So, we create a drug that lowers Blood marker B synthetically, thinking that we will have an impact on Disease X. We don’t measure Disease X directly, because that would take too long.
The mistake here is that, what if Blood marker B being low and leading to lowered rates of Disease X is a reflection of the health of the patient, and NOT because Blood marker B itself is low? Time and time again we see that the use of surrogate end markers in research leads to WORSE outcomes when we artificial lower Blood marker B.
The bottom line is that many of us blindly follow our doctor’s advice to take some medication and we think that there is solid research behind this particular use of the drug.
Sadly, this is not often the case. You may be given this drug because it will make your numbers look better, not because it has been shown to avoid YOUR concern such as a heart attack, stroke, diabetes, osteoporosis or dementia.
Which brings us to this particular study done by the Cochrane group. Before we get into the results, you need to first understand that the what Cochrane Collaboration is all about. In their own words:
“The Cochrane Collaboration is an international network of more than 28,000 dedicated people from over 100 countries. We work together to help healthcare providers, policy-makers, patients, their advocates and carers, make well-informed decisions about health care, by preparing, updating, and promoting the accessibility of Cochrane Reviews – over 5,000 so far, published online in the Cochrane Database of Systematic Reviews, part of The Cochrane Library. We also prepare the largest collection of records of randomised controlled trials in the world, called CENTRAL, published as part of The Cochrane Library.”
In other words, this is THE group that can tear apart the medical research on a topic and filter through the bad study designs and bias that can clog up the true results of a study.
So what did they find out about high blood pressure medications used to lower mild hypertension (systolic blood pressure <160 and diastolic blood pressure <100)?
Not really a whole lot. In the studies reviewed, there was no evidence of a protective benefit from using high blood pressure medication in these patients. No lowered rate of heart attacks, stroke or death.
Let’s be clear–this doesn’t mean there is NOT a benefit, it just means there is no research to prove it. Now that we’ve been clear, let’s be honest…
Millions of dollars thrown into research for drugs to lower blood pressure. BILLIONS of dollars paid annually for people to take these medications. I’m thinking that, if there was an data to truly prove that they work, the drug companies would’ve been hoisting the research up on a pedestal for everyone to see.
The sad part is that I don’t think that these recommendations are going to be widely adopted. Dogma rules in medicine and it takes decades to change behaviors. It has been almost 4 years since the research linking stroke and diabetes with beta blockers for high blood pressure was published, and yet these drugs are still standard treatment for high blood pressure.
I have previously posted on other side effects associated with hypertension drug use and this can be read by clicking here.
The bottom line is that we should lower high blood pressure with lifestyle, not with drugs. Only then can you be sure that you’re going to lower your risk of diabetes, heart disease, stroke and deaths.
So did you do to lower your high blood pressure?