To echo what has been mentioned earlier, and confusion with studies, you might enjoy Dr. Kendrick's newer book Doctoring Data, and his blog web sight also. I did. Not mentioned in the Washington Post article is if the percentage findings are absolute risk or relative risk. What you want to know is the absolute risk. Sadly, almost always reported in the press is relative risk, which can be highly misleading.
One of the points Dr. Kendrick's brings up with blood pressure is that measurements over the years are being lowered, resulting in an increase in the number of patients on blood pressure medications. He also looked into the question then does lowering it with medications do any good for patients? One of the early studies done on this found basically no benefit, at least when it came to avoiding heart disease.
I guess in my opinion if looking to avoid a heart attack, taking blood pressure medication or not, it might be best to not concentrate on blood pressure, but take consideration of other areas of health too.
"Does treating high blood pressure do any good?"
http://drmalcolmkendrick.org/2012/04/02 ... -any-good/
one of the doctors write ups:
...At which point, something very strange happens. Instead of calling this ‘a raised blood pressure where no cause can be found,’ the medical profession decided to turn a clinical sign into a disease. This disease is Essential Hypertension, which literally means ‘a raised blood pressure where no cause can be found.’ But you have to admit that essential hypertension sounds rather more impressive.
Once it became a de-facto disease, it can be ‘treated.’ And so it came to pass that, over time, a whole series of drugs were developed. Some reduce the blood volume, some relax the blood vessels, some block the production of hormones designed to raise blood pressure, and others prevent the heart pumping too hard.
They come by names such as thiazide diuretics, beta-blockers, alpha-blockers, angiotensin converting enzyme inhibitors, angiotensinogen II inhibitors etc. etc. After statins, these are the most prescribed type of medications. Around the world, hundreds of millions of people take them each and every day.
This mass pharmacological assault happened before anyone had actually established that lowering blood pressure was actually beneficial. There had been a couple of short term studies on people with very high blood pressure. These did show benefit.
However, when it came to moderately raised blood pressure, there were absolutely no studies at all. Yes, you did read that right. No studies. It was not until the 1970s that anyone actually set out to answer this rather fundamental question by setting up a major study. The UK Medical Research Council (MRC) study.
Recruitment started in 1973. Seven hundred thousand people were contacted, and half a million people accepted an invitation to participate. As is the way with such things, this enormous initial number was whittled down to just under eighteen thousand people who had a diastolic blood pressure between 90 – 109, and a systolic pressure below 200.
The eagerly awaited results were released in 1985. I remember the year well, as I was at a cardiovascular conference at the time. Everyone was convinced that that there would be major benefits.
And what were the results? Well, if you get down to the most important outcome of all, which is overall mortality, there were 248 deaths in the treated group and 253in the placebo group2. Or to put this another way: 248 out of 9000 died in the treatment arm died, and 253 out of 9000 died in the placebo arm:
Overall mortality: 248/9000 = 2.75% (treatment group)
Overall mortality: 253/9000 = 2.81% (placebo)
The total difference in deaths was seven. The absolute percentage difference in deaths was 0.06% over five years. There was no difference in the death rate from heart disease.
I remember thinking at the time. ‘Blimey that should throw the cat amongst the pigeons. We are going to have to re-think this area.’ How wrong could one man be? Because the result of the MRC study was that absolutely nothing changed. There was no re-think, no fundamental review, nothing....
