SPRINT Hypertension study should not change blood pressure treatment
A new regimen recommended by NIH for treating adults 50 years and older with hypertension (high blood pressure) is making big news.
It significantly reduced the rates of heart attacks, heart failure, and stroke by 30 percent and lowered the risk of death by 25 percent.
The NIH research team was so excited by the results that they stopped the program so they could share the news globally as soon as possible.
And no wonder—79 million American adults have high blood pressure—29 percent. It’s a major cause of heart disease and stroke, the first and third leading causes of death in the United States. It’s a crisis-level problem just about worldwide.
So what’s it all about?
Blood pressure basics
You’ve seen the ubiquitous blood pressure notation: expressed 120/80 for systolic “over” diastolic pressure.
Your systolic blood pressure is a measure of how hard your heart works when it beats to pump blood.
Your diastolic blood pressure is the pressure in your arteries between heartbeats.
The narrower your arteries—caused by aging or bad habits—the harder your heart has to work, and the more stressed your arteries become over time.
Danger lurks there—that stress can cause microscopic tears, which your brilliant body heals with scar tissue. But, unfortunately, these scars are the perfect home for fat, cholesterol, and other substances we collectively call plaque to cling onto. Plaque narrows arteries further, making the heart beat harder, and the cycle continues…dangerously downward for your health.
The NIH project, called SPRINT (for Systolic Blood Pressure Intervention Trial), investigated the health benefits, or not, of lowering high blood pressure (150 and above) from the conventional medical target, 140 (pre-hypertension), to 120 (normal, healthy blood pressure).
That first, excited report said “Yes, for sure.”
Imagine the hope that inspired.
And, of course, the doubts. Including my own.
Too many meds?
If you’re not a fan of drug-based interventions, there was plenty of reason not to celebrate this nominal breakthrough. The research compared results—heart attacks, heart failure, and stroke—in one group taking the current, conventional two-drug treatment with another group taking three drugs.
It’s natural for our blood pressure to increase temporarily when we’re angry. Mine goes up when I wrack my brain for even some basic logic here.
Knowing that every drug on the planet can cause side effects, and can interact very badly with other drugs … how can a triple-drug cocktail be the right way to go?
Something was missing in the data
According to other skeptics, what was missing in the data was…the data.
NIH didn’t release any of the evidence, statistics, or even which kind of drugs were used in the trial. Those are to be delivered in a few months’ time when the full study is published.
Maybe the three un-named drugs comprise a true breakthrough cocktail. That could change some doubting minds, but not mine. I continue to advocate and prescribe natural protective, corrective, preventive interventions—diet, lifestyle, and some carefully targeted supplements.
“It’s frustrating because they make huge, huge claims and supply no data,” said David Cundiff, MD, an internal medicine physician and author.
Also worrisome: the SPRINT conclusions contradict findings from previous reviews and recommendations, including a 2012 study that found no evidence that drugs benefit patients with mild hypertension, defined as systolic BP of 140 to 159—pretty much the same kind of folks in the NIH study.
What should we do?
There are so many ways to prevent and reduce high blood pressure—most of them focused on good foods and good habits:
- Quit smoking, drink alcohol only in moderation, drink only sips or no soda, juice, coffee, and other caffeinated or sugary drinks.
- Sleep at least seven to eight hours a night.
- Drink water. Half an ounce per pound of body weight per day, e.g., if you weigh 160 pounds, you drink 80 ounces of water—10 eight-ounce glasses per day. Not a big ask, but a big benefit. It thins your blood, which helps your heart.
- Eat smart and clean. Whole, fresh foods, including lean meats and poultry, organic fruits and vegetables, unsalted nuts and seeds, legumes, whole grains, low-fat dairy (or alternatives e.g., almond or rice milk), and healthy fats like avocado, olive, and sesame oils. Celery, garlic, raw cacao, almonds, cayenne pepper, and eggs—proven heart-friendly.
- Avoid high-sodium foods, fast food, sugar, processed snacks or meals, and trans fats.
- De-stress purposely. We can’t eliminate stress. But don’t wait to get over it—be proactive about it with therapy, meditation, yoga, tai chi, qigong, deep breathing, visualization, and exercise.
- Exercise is essential to decreasing the risk of heart disease, stroke, and countless other conditions. Try just simply walking for 10–15 minutes a day, and gradually increasing your time and distance, or try interval and weight training.
Take blood pressure-supportive supplements. They work much the same way as prescription blood pressure drugs, but without nasty side effects.
- Nattokinase (from fermented soy beans) prevents hardening of blood vessels and inhibits abnormal thickening of blood.
- Grape seed extract opens up the blood vessels, which can significantly reduce systolic pressure and heart rate.
- Hawthorn contains antioxidants that help dilate blood vessels and protect the arteries from damage. It may reduce diastolic blood pressure.
- Omega-3 essential fatty acids combat inflammation, lower blood pressure, and enhance heart health. They also act as natural blood thinners.
- Coenzyme Q10 (CoQ10) protects the heart by preventing inflammation and oxidative damage in the arteries. It also may lower both systolic and diastolic blood pressure without major side effects.
What should we not do?
The one thing we must not do is take the NIH pronouncement as conclusive, and heaven forbid, actionable. Changing 29 million prescriptions would be a nightmare in itself—especially if it’s for little or no reason. And the idea of putting millions of new patients on anti-hypertension medications just doesn’t sit well with me.
Stay tuned. I know I will.
Last Updated: August 16, 2018
Originally Published: October 12, 2015