Hypertension facts and achievements from a patient’s point of view

The range of responsibilities and services offered by physicians has changed considerably since the 1960s. In addition to the treatment of acute illnesses, the protection of patients who feel perfectly healthy against risks caused by high blood pressure, increased cholesterol or blood glucose levels requires more and more of the doctors’ time.

The circumstances where a treatment is required usually have nothing to do with the people’s feeling of well-being or doctors’ observations. These insights are based on clinical studies and assumptions resulting therefrom, which are discussed by experts and passed on to physicians in the form of guidelines. Depending on which of the studies the experts take into account, the limits or risks may shift in one direction or another and can therefore affect many people.

The success of the treatments is usually proven by repeated measurements, this time around with redefined values. The treating physicians are usually unable to determine the actual reason for the treatment, such as a decrease in circulatory diseases, and they, too, must rely on the judgment of the experts.

Common diseases were defined worldwide, derived from this risk prevention. In Germany, each of these common diseases affect at least 5 million people, and hypertension as many as 24 million people. It seems the treatment of hypertension in one third of the population is not enough. In the USA, a new reduction of the limit values unlocked a new potential of about 30 million people, who now may also receive life-long prescriptions of antihypertensive drugs.

It is time to try to figure out what has been achieved with this practice in the last 10 years and why a further lowering of the limits appears to be necessary.

If one counts the number of people, the medical associations of the so-called common diseases in Germany (hypertension, obesity, diabetes, ...) claim themselves eligible for treatment, then this number is as large as that of the adult population in Germany.

hypertension, obesity, diabetes  Read here what triggered this page

For more than two decades, all media have been spreading warnings about the "silent killer", even "the leading cause of death." In addition to strokes, heart and kidney diseases as the long-term consequences of hypertension, now blindness and dementia have also been added to the list. For more than 24 million people – that is one third of the population in Germany – a lifelong prescription of medicines is supposed to help prevent this insidious threat from spreading.

Time and again we hear about studies confirming a reduction of cardiovascular diseases in the order of 25-38%. However, the press releases of a university claim that about half of all hypertensive patients cannot lower their blood pressure sufficiently despite the medication they take and that the permanent strain on their bodies causes other diseases.

Suddenly, more than 30 million people in the US became hypertensive overnight because the limits were lowered even more. While according to the European Guidelines 2018, new limits are not to be made mandatory, the very same guidelines encourage doctors to adopt the lower US limits, provided that the patient is able to tolerate the necessary medication and its dosage.

This situation is about to become a threat for patients, if the degree of tolerable side effects is to decide by how much the blood pressure will be lowered. This raises the question of what exactly has been achieved in the last few decades in the fight against these widespread diseases caused by high blood pressure.

Hypertension Overview  Read what we found so far

Milestones in Hypertension

Ca. 1960
Blood pressure values calculated by Age+100 is tolerated

1970
The WHO is pushing blood pressure reduction. Limit 160/100 mmHg.
One possible consequence of the campaign against high blood pressure could be an „over-medication “.
(Lancet 1970,1,485-89)

1997-1999
Limit reduction from 160/95 mmHg to 140/90 mmHg.
9,8 Million patients

2003
First European Hypertension Guideline. Media campaigns “the silent killer”.
16,1 Million patients

2008
Cochrane study: Lowering blood pressure below 140/90 mmHg is not beneficial
20,1 Million patients

2015
The SPRINT study was discontinued because the expectations of further lowering <140/90 mmHg were exceeded.
23,9 Million patients

Today
European Hypertension Guideline 2018.
130 mmHg should be sought if the patient tolerates the therapy.
24,1 Million patients

High blood pressure patients take antihypertensives for the rest of their lives