Lower Blood Pressure Empowers Longer LifeNovember 2016
The gold standard for identifying beneficial longevityA recent study published in the New England Journal of Medicine further validates Life Extension®’s long-held position that most people should keep their blood pressure below 120/80 mmHg. In this landmark study, those whose blood pressure was aggressively reduced had a 43% lower risk of cardiovascular death.
By William Faloon
- 38% lower relative risk of heart failure;
- 43% lower relative risk of cardiovascular death;
- 27% lower relative risk of mortality overall.
How Life Extension Realized This So Early
New Study Wakes Up Medical Establishment!
Historic Failures to Recognize Disease CausationIt is regrettable that practicing clinicians did not bother to observe that patients with blood pressure readings over 120/80 mmHg had elevated rates of cardiac death. But then again, it took decades of research to raise suspicion of a causative role of cigarette smoking in the development of lung cancer. Physicians in the 1930s were certainly aware that respiratory illnesses happened with greater frequency in smokers. Yet it took decades of published research for the tobacco-disease causation issue to be raised, and it wasn’t until 1964 that the Surgeon General stated that smoking increases risk for a host of deadly illnesses.6 A similar scenario has occurred with the debate as to what the safe upper limit for blood pressure should be. Persuasive evidence and common sense long ago indicated that Life Extension’s recommendation of 115/75 mmHg would spare many lives compared to the establishment’s position that blood pressure readings up to 139/89 mmHg were alright.
SIMILAR TO CONTROVERSY ABOUT GLUCOSE
How Many Preventable Deaths?Each year about 2.5 million Americans die.7 This number is expected to steadily rise as the aging population increases. Life Extension’s fundamental mission is to reverse this upward mortality trend in aging humans. We wanted to glean some idea as to how many needless deaths occurred because it took the medical establishment so long to recognize the lifesaving benefits of lower blood pressure ranges. So we took the most conservative percentage of death reduction found in the SPRINT study, which was a 27% reduction in overall mortality in people age 50 and older. We then did a calculation using the approximate 2 million total deaths that have occurred each year in the United States in people age 50 and older dating back to year 1985. Based on this 27% reduction in all-cause mortality, about 540,000 American lives could have been spared each year had the medical establishment adopted Life Extension’s recommendation to keep blood pressure levels below 120/80 mmHg. This number of 540,000 annual deaths that could have been prevented is of course an exaggeration. It assumes that everyone ages 50 and older would have had their blood pressure checked and followed an aggressive program to reduce it to safe ranges. The reality is that hypertension is a “silent killer” and many people don’t know they have it. Patients prescribed antihypertensive drugs and lifestyle changes often don’t comply. There were nonetheless tens of millions of Americans treated for hypertension since 1985, with the physician’s goal being to reduce it only to under 140/90 mmHg. This is where the needless carnage arose and where mainstream medicine needs to look at this failure as an example of the cost in human lives that occurs when published studies and common sense are discarded.
Our Delicate Vasculature
Fallacy of “Prehypertension”
- 55% increased risk of cardiovascular disease,
- 50% increased risk of coronary heart disease,
- 71% increased stroke risk.
Do Not Rush to Lower Blood Pressure
OUR PRECIOUS ENDOTHELIUMOur inner arterial lining is called the endothelium. The endothelium is an ultra-thin, one-cell-thick layer of cells. It loses youthful function in response to normal aging. An underappreciated factor in the development of cardiovascular disease is endothelial dysfunction. The consequences of endothelial dysfunction are diminished circulation, high blood pressure, thrombosis, and atherosclerosis, all of which are major causes of stroke and heart attack.27-31 Fortunately, astute scientists have discovered potent natural methods to tackle the underlying causes of endothelial dysfunction. In addition to nutritional/lifestyle interventions, maintaining optimal blood pressure readings is essential to protect against loss of endothelialfunction.
Providing You with Real World GuidanceThe encouraging news about all this is that if one intelligently embarks on a program to reduce their blood pressure to more optimal ranges, there are simple blood tests available that can identify if adverse effects are occurring in response to overly aggressive drug treatment. These and other commonsense approaches to achieving optimal blood pressure levels are described in articles contained in this month’s issue. Readers should understand that the more one is willing to make healthier lifestyle changes, the less in the way of antihypertensive drugs they are likely to need, which should translate into a lower side effect risk profile. We published an article 1.7 years ago that describes the ideal antihypertensive drug to begin with. This drug (telmisartan) not only lowers blood pressure in what we consider the most efficient manner, but has side benefits that include improvements in endothelial function and survival not seen with other antihypertensive medications.
MAJORITY OF ADULTS ARE HYPERTENSIVE AND PREVALENCE INCREASES AS WE AGE!
75 years and over
75 years and over
Challenges in Persuading Our SupportersI’ve been involved in helping people avoid degenerative illness since the 1970s. One of my greatest challenges has been to persuade health-conscious individuals that they may need a prescription medication to optimize their blood pressure. An argument I’ve encountered from people who eat properly, exercise, and take dietary supplements is that they don’t think they have to worry about slightly elevated blood pressure. While all these healthy practices can help protect against endothelial dysfunction, one cannot overlook the structural damage inflicted to our vasculature by higher-than-optimal blood pressure. I also have run into resistance by people who think a blood pressure check several times a year at their doctor’s office is sufficient. Based on my personal experience with my at-home blood pressure monitor, I know that my systolic pressure can range from a low of 95 mmHg to a high of 140 mmHg under stressful circumstances. When I see my blood pressure any level above 115/75 mmHg, I take an extra 40 mg dose of the drug telmisartan to reduce it. If I did not have an at-home blood pressure monitor, I would never have known my blood pressure spiked this high. To make matters worse, your endothelium does not give you credit for the period of the day when your blood pressure is lower. It is during periods when blood pressure spikes up that massive vascular damage occurs. So I hope every one of you has an at-home blood pressure monitor based on our previous recommendations. As you can see on page 14, the price has come down considerably from what they cost just a few years ago. To learn more about the blood pressure lowering drugs we favor, you can log on at no cost to: LifeExtension.com/hypertension These drug recommendations are not based on commercial interests, just our sincere desire to keep you alive and healthy for decades to come.
- Sprint Research Group, Wright JT, Jr., Williamson JD, et al. A Randomized Trial of Intensive versus Standard Blood-Pressure Control. N Engl J Med. 2015;373(22):2103-16.
- Available at: http://www.mayoclinic.org/diseases-conditions/high-blood-pressure/basics/definition/con-20019580. Accessed August 22, 2016.
- Available at: http://www.cdc.gov/bloodpressure/facts.htm. Accessed June 14, 2016.
- Huynh-Hohnbaum AL, Marshall L, Villa VM, et al. Self-Management of Heart Disease in Older Adults. Home Health Care Serv Q. 2015;34(3-4):159-72.
- Available at: http://www.cdc.gov/heartdisease/facts.htm. Accessed August 22, 2016.
- Available at: https://profiles.nlm.nih.gov/NN/B/B/M/Q/. Accessed November 28, 2015.
- Available at: http://www.cdc.gov/nchs/fastats/deaths.htm. Accessed August 22, 2016.
- Dharmashankar K, Widlansky ME. Vascular endothelial function and hypertension: insights and directions. Curr Hypertens Rep. 2010;12(6):448-55.
- Rosendorff C, Black HR, Cannon CP, et al. Treatment of hypertension in the prevention and management of ischemic heart disease: a scientific statement from the American Heart Association Council for High Blood Pressure Research and the Councils on Clinical Cardiology and Epidemiology and Prevention. Circulation. 2007;115(21):2761-88.
- Mukherjee D, Campbell CL. Optimal management of hypertension in patients with ischemic heart disease. Cardiovasc Hematol Agents Med Chem. 2009;7(3):198-205.
- Agbor-Etang BB, Setaro JF. Management of Hypertension in Patients with Ischemic Heart Disease. Curr Cardiol Rep. 2015;17(12):119.
- Johansson BB. Hypertension mechanisms causing stroke. Clin Exp Pharmacol Physiol. 1999;26(7):563-5.
- Chalmers J, Todd A, Chapman N, et al. International Society of Hypertension (ISH): statement on blood pressure lowering and stroke prevention. J Hypertens. 2003;21(4):651-63.
- Available at: http://www.medscape.com/viewarticle/473113. Accessed August 23, 2016.
- Bidani AK, Griffin KA. Long-term renal consequences of hypertension for normal and diseased kidneys. Curr Opin Nephrol Hypertens. 2002;11(1):73-80.
- Whitworth JA. Progression of renal failure — the role of hypertension. Ann Acad Med Singapore. 2005;34(1):8-15.
- Faraco G, Iadecola C. Hypertension: a harbinger of stroke and dementia. Hypertension. 2013;62(5):810-7.
- Joas E, Backman K, Gustafson D, et al. Blood pressure trajectories from midlife to late life in relation to dementia in women followed for 37 years. Hypertension. 2012;59(4):796-801.
- Skoog I, Lernfelt B, Landahl S, et al. 15-year longitudinal study of blood pressure and dementia. Lancet. 1996;347(9009):1141-5.
- Shah NS, Vidal JS, Masaki K, et al. Midlife blood pressure, plasma beta-amyloid, and the risk for Alzheimer disease: the Honolulu Asia Aging Study. Hypertension. 2012;59(4):780-6.
- Ninomiya T, Ohara T, Hirakawa Y, et al. Midlife and late-life blood pressure and dementia in Japanese elderly: the Hisayama study. Hypertension. 2011;58(1):22-8.
- Huang Y, Wang S, Cai X, et al. Prehypertension and incidence of cardiovascular disease: a meta-analysis. BMC Med. 2013;11:177.
- Cushman WC, Evans GW, Byington RP, et al. Effects of intensive blood-pressure control in type 2 diabetes mellitus. N Engl J Med. 2010;362(17):1575-85.
- Hausberg M, Lang D, Barenbrock M, et al. Large artery wall properties — what is relevant for the classic management of hypertension?. Dtsch Med Wochenschr. 2005;130(46):2657-61.
- Available at: http://www.lifeextension.com/magazine/2015/3/best-drug-to-treat-hypertension/page-01. Accessed August 23, 2016.
- Available at: http://www.reuters.com/article/us-health-heart-bloodpressure-idUSKCN0SY2F920151109. Accessed August 23, 2016.
- Fordjour PA, Wang Y, Shi Y, et al. Possible mechanisms of C-reactive protein mediated acute myocardial infarction. Eur J Pharmacol. 2015;760:72-80.
- Eelen G, de Zeeuw P, Simons M, et al. Endothelial cell metabolism in normal and diseased vasculature. Circ Res. 2015;116(7):1231-44.
- Huveneers S, Daemen MJ, Hordijk PL. Between Rho(k) and a hard place: the relation between vessel wall stiffness, endothelial contractility, and cardiovascular disease. Circ Res. 2015;116(5):895-908.
- Seals DR, Jablonski KL, Donato AJ. Aging and vascular endothelial function in humans. Clin Sci (Lond). 2011;120(9):357-75.
- Pearson JD. Endothelial cell function and thrombosis. Baillieres Best Pract Res Clin Haematol. 1999;12(3):329-41.
- Available at: http://www.cdc.gov/nchs/fastats/older-american-health.htm. Accessed August 23, 2016.