The medical community, organizations and government agencies couldn't be clearer: hypertension (high blood pressure) is a silent killer. You may not feel anything wrong, but if you've got it, your risk of strokes and heart failure goes way up. Therefore it's essential to monitor and treat this deadly condition.
They're all wrong. Hypertension is not a disease that needs to be cured. It may be a symptom of a problem, but not a problem itself, just like fever is a symptom, not the underlying problem. By treating it as a disease and giving drugs to lower blood pressure, the medical establishment makes patients less healthy and raises costs substantially. With a few exceptions, we would all be better off ignoring blood pressure and most of the associated advice.
Drugs for "Curing" Hypertension
The single most prescribed drug in the US is for lowering cholesterol. But most prescriptions for a disease are to reduce blood pressure.
Here's the story with blood pressure pills.
In fact, a majority of the most prescribed drugs in the U.S. are used to treat high blood pressure or symptoms of it. That’s because 108 million or nearly half of adults in the U.S. have hypertension or high blood pressure.
Is Hypertension a Disease?
There is no doubt that blood pressure can be measured and that it varies greatly. What is hypertension? As I describe here, currently it's a systolic pressure reading above 120 (until 2017 it was above 140). There are lots of things you can measure about people. What makes this measurement bad?
There's a clue buried deep in Doctor-language, a clue that is nearly always missed -- but it's one that doctors with a basic education should know. The official name for high blood pressure is essential hypertension. What's that? Let's ask Dr. Malcolm Kendrick, a long-experienced cardiologist:
At medical school we were always taught – and this has not changed as far as I know – that an underlying cause for high blood pressure will not be found in ninety per cent of patients.
Ninety per cent… In truth, I think it is more than this. I have come across a patient with an absolute, clearly defined cause for their high blood pressure about five times, in total, and I must have seen ten thousand people with high blood pressure. I must admit I am guessing at both figures and may be exaggerating for dramatic effect.
Whatever the exact figures, it is very rare to find a clear, specific cause. The medical profession solved this problem by calling high blood pressure, with no identified cause, “essential hypertension”. The exact definition of essential hypertension is ‘raised blood pressure of no known cause.’ I must admit that essential hypertension certainly sounds more professional than announcing, ‘oh my God, your blood pressure is high, and we do not have the faintest idea why.’ But it means the same thing.
Hypertension = your blood pressure number is high. Kind of like having a high temperature, which we call a "fever," right? Wrong. When you get a fever, doctors first make an effort to determine the cause of the fever! What an idea! The fever is a clue that something is wrong, not the problem itself! Here's the real, bottom-line clue: When you treat fever you treat the underlying cause e.g. bacterial infection, NOT the fever itself! If we treated fever the way we treat hypertension, we would give drugs whose sole purpose was to lower the body temperature, ignoring the underlying bacterial infection that caused the fever. Wouldn't do any good! Maybe we'd sweat less, but the bacteria would rage away inside our bodies. But high blood pressure? Doctors ignore the cause and "treat" the symptom, which can often do more harm than good -- except of course for the drug makers, who make out just fine.
Makes me sick.
Causes of hypertension
From Kendrick:
So, why does the blood pressure rise in some people, and not in others. It is an interesting question. You would think that, by now, someone would have an answer, but they don’t. Or at least no answer that explains anything much.
Just as fever is caused by an infection (or something else), could it be possible that hypertension results from some underlying problem? Kendrick again:
Looking at this from the other direction, could it be that cardiovascular disease causes high blood pressure. Well, this would still explain why the two things are clearly associated, although the causal pathway may not be a → b. It could well be b → a.
I must admit that I like this idea better, because it makes some sense. If we think of cardiovascular disease as the development of atherosclerotic plaques, leading to thickening and narrowing of the arteries then we can see CVD is going to reduce blood flow to vital organs, such as the brain, the kidneys, the liver, the heart itself.
These organs would then protest, leading to the heart pumping harder to increase the blood flow and keep the oxygen supply up. The only way to increase blood flow through a narrower pipe, is to increase the pressure. Which is what then happens.
Over time, as the heart is forced to pump harder, and harder, the muscle in the left ventricle will get bigger and bigger, causing hypertrophy. Hypertrophy means ‘enlargement.’ So, in people with long term, raised blood pressure, we would expect to see left ventricular hypertrophy (LVH). Which is exactly what we do see.
He goes on to give lots of detail about how this takes place, if you're interested.
Correlation and Causation
There's a little problem that everyone who knows about science and statistics is supposed to know. It's the difference between correlation and causation. Two things seem to happen at the same time. They are correlated. No problem. But does one of the cause the other? That's a whole other thing, and it's super-important. At McDonald's, burgers and fries are often seen together. They're correlated. Did the burger cause the fries? Fries cause the burgers? Nope. They're just listed together on the menu and lots of people like them together.
How about knife cuts and bleeding? Definitely correlated. Causation? By looking at repeated cases of knives making cuts, you can determine that putting a knife into someone's skin nearly always causes bleeding.
This is the problem at the heart of hypertension -- except perhaps in extreme cases, hypertension can be correlated with heart attacks and strokes -- but it can't be shown to cause them in the vast majority of cases.
The range of blood pressure
The authorities don't like to talk about this, but blood pressure varies HUGELY not just from person to person, but also by age and for a single person during the day!
Here's something to give you the idea from a scientific paper:
The range of pressure for a single person can be rather larger. I just took my pressure this morning. The systolic was 126. In the previous days the readings were 159 and 139.I have taken my pressure with different devices over a year, and that variation is not unusual. It can vary that much in a couple hours, depending on my activity level.
It is well-known in the medical community that blood pressure varies naturally with age, generally rising as you get older. Has anyone documented this statistically? If they have, I can't find it. Generally, what is normal is roughly 100 plus your age, so a 50 year old man would have 150, roughly 10 less for women. Here is an interesting description of the age factor from a former NASA astronaut and doctor.
The assumed causation fails to hold
A surprising amount of modern medical misinformation goes back to the diet-heart hypothesis put forward by Ancel Keys and supported by the seven countries study. It's what led to the obesity-causing fat-is-bad diet recommendations and the ongoing harm of reducing blood cholesterol using statins. Out of the same witch's brew came the notion that high blood pressure causes heart disease.This notion was supposedly locked down by the famous Framingham study, which continues to this day.
In the year 2000, the edifice crashed when a careful review was published in the journal of the European Society of Cardiology, "There is a non-linear relationship between mortality and blood pressure." It includes references to the original Keys study and many following journal articles.
The article is prefaced by a quote that is so appropriate, I can't help but share it with you:
"For every complicated problem there is a solution that is simple, direct, understandable, and wrong." H. L. Mencken
The authors start by explaining the current paradigm:
"the relation of SBP (systolic blood pressure) to risk of death is continuous, graded and strong..." The formulation of this "lower is better" principle ... forms the foundation for the current guidelines for hypertension.
They point out that Ancel Keys himself concluded that "the relationship of overall and coronary heart disease death to blood pressure was unjustified."
They went on to examine the detailed Framingham study data.
Shockingly, we have found that the Framingham data in no way supported the current paradigm to which they gave birth.
...
Systolic blood pressure increases at a constant rate with age. In sharp contrast to the current paradigm, we find that this increase does not incur additional risk. More specifically, all persons in the lower 70% of pressures for their age and sex have equivalent risk.
Cardiologist Kendrick in his recent book Doctoring Data points out
Has this paper ever been refuted? No, it has not. Sadly, it was given the worst possible treatment that can be dished out by the medical establishment. It was completely ignored.
...
The benefits of blood-pressure lowering, whatever the level, became so widely accepted years ago that it has not been possible, ethically,[viii] to do a placebo-controlled study for a long time. I am not aware of any placebo-controlled trials that have been done in the last twenty years, or so.
A bit of sanity
The same year (2017) the AHA and cardiologists were lowering the target blood pressure for everyone from 140 to 120, a group representing family physicians published an official guideline for treating hypertension in adults age 60 and over. Their method was rigorous, taking into account all available studies. Here is their core recommendation:
ACP and AAFP recommend that clinicians initiate treatment in adults aged 60 years or older with systolic blood pressure persistently at or above 150 mm Hg to achieve a target systolic blood pressure of less than 150 mm Hg to reduce the risk for mortality, stroke, and cardiac events. (Grade: strong recommendation, high-quality evidence).
What a breath of fresh air! And completely in line with this data-driven review that showed that a large number of people taking anti-hypertensive drugs just 1 in 125 were helped (prevented death), while 1 in 10 were harmed by side effects. Also in line with this careful study of people with elevated blood pressure in the range of 140-160; the study showed that none were helped by drugs, while 1 in 12 were harmed.
BTW, if you're not familiar with the concept of NNT, you should learn about it. It's crucial.
Hypertension Drugs can hurt you
Doctors dish out hypertension drugs like candy. It's often the case that two different kinds of drugs will be required to get your blood pressure to "safe" levels. For reasons that don't seem to be studied, it's rare indeed for doctors to mention side effects; yet in repeated studies, the generally data-suppressing researchers can help but mention that the side effects are so bad that roughly 10% of study participants drop out of the study! (See above for references.)
There are good lists of side effects at Drugs.com. Here's some information about Amlodipine:
Side effects requiring immediate medical attention
Along with its needed effects, amlodipine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur while taking amlodipine:
More common
- Swelling of the ankles or feet
Less common
- Chest tightness
- difficult or labored breathing
- dizziness
- fast, irregular, pounding, or racing heartbeat or pulse
- feeling of warmth
- redness of the face, neck, arms, and occasionally, upper chest
Rare
- Black, tarry stools
- bleeding gums
- blistering, peeling, or loosening of the skin
- blood in the urine or stools
- blurred vision
- burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
- chest pain or discomfort
- chills
- cold and clammy skin
- cold sweats
- confusion
- cough
- dark yellow urine
- diarrhea
- dilated neck veins
- dizziness or lightheadedness when getting up from a lying or sitting position
- extra heartbeats
- fainting
- fever
- itching of the skin
- joint or muscle pain
- large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
- numbness and tingling of the face, fingers, or toes
- pain in the arms, legs, or lower back, especially pain in the calves or heels upon exertion
- painful or difficult urination
- pale, bluish-colored, or cold hands or feet
- pinpoint red or purple spots on the skin
- red, irritated eyes
- redness of the face, neck, arms, and occasionally, upper chest
- redness, soreness or itching skin
- shakiness in the legs, arms, hands, or feet
- slow or irregular heartbeat
- sore throat
- sores, ulcers, or white spots on the lips or in the mouth
- sores, welting, or blisters
- sudden sweating
- sweating
- swelling of the face, fingers, feet, or lower legs
- swollen glands
- trembling or shaking of the hands or feet
- unsteadiness or awkwardness
- unusual bleeding or bruising
- unusual tiredness or weakness
- weak or absent pulses in the legs
- weakness in the arms, hands, legs, or feet
- weight gain
- yellow eyes or skin
Those are the issues with just one of the many hypertension drugs, one of the most widely prescribed!
Conclusion
Blood pressure varies greatly, reflecting the human body's amazing self-regulation systems. In the vast majority of cases, blood pressure goes up with age. Lowering it by drugs does more harm than good. Except perhaps in extreme cases, high blood pressure does not cause disease. When pressure is extremely high, a search for the cause should be made. The ongoing focus on hypertension as a disease reflects nothing but the stubborn refusal of the medical establishment to admit that they were wrong, and of the pharma companies to give up a lucrative market.
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