Last year, millions of people were reclassified overnight as having high blood pressure. The , set by the American Heart Association and the American College of Cardiology, were intended to alert people to any rising blood pressure at an earlier stage, 聽helping them to get on top of the problem sooner.
However, the decision ignores the potential harms of slapping people with disease labels, according to an analysis published by Australian public-health experts on Monday. They estimate that of newly diagnosed individuals will end up worse off.
These 80 per cent have less than a 10 per cent chance of having a heart attack or stroke in the next decade because they won鈥檛 have any other big risk factors besides elevated blood pressure. Nevertheless, it will still be a blow to be moved to the new category, with safe limits lowered from a blood pressure of 140/90 to 130/80 mmHg. Research has shown that being diagnosed with this condition can cause .
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Reassuring meds
The disease label could also lead to unnecessary treatment. Although the new guidelines recommend lifestyle changes such as eating less salt, drinking less alcohol and exercising more for this relatively low-risk group, many will seek the reassurance of medication, which can have side effects like dizziness and nausea.
Moreover, in countries like the US, being diagnosed with a medical condition like high blood pressure can affect insurance coverage and increase premiums.
The analysis found that only 9 per cent of newly diagnosed people are likely to benefit. These are individuals with other conditions such as diabetes or kidney disease who are already at higher risk of having a heart attack or stroke. The remaining 11 per cent are expected to have neutral outcomes.
The goalpost shifting is part of a larger trend towards what many see as 鈥�too much medicine鈥�. A 2013 study found that the definitions of had been expanded since 2000 to make more people eligible for medications.
Industry ties
Some people have suggested that this might be down to industry influence. And the 2013 study found that on average, three-quarters of the people on panels proposing new guidelines had financial ties to drug companies, but the authors point out that there is no evidence that these ties have influenced decision-making. 鈥淥ur data do not support any inference industry ties are associated with widening definitions or failure to rigorously assess potential harms of that widening,鈥� they say. In the case of the latest blood pressure guidelines, all authors declared they had no industry ties in the year prior to writing them.
Even so, the guidelines have been criticised by other doctors. The American College of Physicians said the guidelines and the American Academy of Family Physicians said they were . This found that intensive blood pressure lowering below 120 mmHg had better cardiovascular outcomes than the traditional 140 mmHg target, but there are concerns that the results .
So while the professionals battle it out, it鈥檚 probably worth being cautious and remembering that the new guidelines have mainly been designed to encourage healthier lifestyles, not to make you worry.
