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High blood pressure, often called the "silent killer," is branded as a major cause of heart disease and stroke, with doctors pushing for readings as low as 120/70, even for older adults. For decades, medical guidelines have tightened, labelling more people as hypertensive and prescribing lifelong medications. But is this relentless focus on lower numbers backed by solid science, or is it driven by profit? The truth is, many assumptions about high blood pressure are myths, and the push to medicate everyone, especially seniors, may be doing more harm than good. Let's unravel these misconceptions, explore how guidelines have shifted, and expose Big Pharma's role in this medical obsession!
We're told that high blood pressure damages arteries, leading to heart attacks and strokes, so it must be lowered at all costs. But what if this gets the story backward? Some evidence suggests elevated blood pressure is the body's attempt to compensate for poor circulation, not the root cause of heart disease. When blood flow to organs like the kidneys is blocked, say, by stiffened arteries or clumped blood cells, the body raises pressure to keep blood moving. Nearly a century ago, researchers noticed that hypertensive patients often had "blood sludging," where red blood cells clump together, clogging small vessels and increasing pressure. This suggests the problem starts with circulation, not the pressure itself.
Studies show that aggressively lowering blood pressure doesn't always prevent heart disease. Large trials from the 1970s and 1980s found that treating mild hypertension slightly reduced strokes, but had almost no effect on heart attacks or overall death rates. A major review in 2009 confirmed that dropping systolic pressure below 135 offers little benefit compared to 140, and the side effects, like dizziness or kidney problems, often outweigh the gains. Worse, up to a quarter of hypertension diagnoses are wrong, caused by things like stress during a doctor's visit (white coat hypertension) or using the wrong cuff size. Yet, millions are prescribed drugs based on these flawed readings.
Today's push for blood pressure readings like 120/70, even in older adults, is a sharp departure from the past. Decades ago, doctors didn't treat high blood pressure unless it was severe, like over 200 systolic. In the 1970s, guidelines targeted diastolic pressure above 90, with treatment starting around 160/100. By the 1980s, the focus shifted to systolic pressure, but thresholds stayed around 140/90. Then, in 2017, new guidelines redefined hypertension as 130/80, suddenly labelling nearly half of U.S. adults as hypertensive, up from a third. For seniors, this is even more dramatic: nearly 80% of those over 74 now qualify as hypertensive, and most are told to start medications.
This shift ignores how aging affects the body. As we get older, arteries stiffen, and higher pressure is often needed to push blood to vital organs like the brain and kidneys. Forcing readings down to 120/70 can starve these organs, leading to serious problems. Studies show that seniors with blood pressure below 130/80 face an 8–19% higher risk of death. Low pressure also increases the chance of falls, by 40–130% in older adults, causing fractures or worse. Cognitive decline is another risk, as the brain needs steady blood flow to function. Doctors in the past understood this, often allowing readings up to 150/90 for those over 60 to avoid these dangers. So why the change?
The answer lies partly in profit. Each time guidelines lower the hypertension threshold, millions more people qualify for medications, boosting pharmaceutical sales. Blood pressure drugs are a multi-billion-dollar industry, with companies like Pfizer and Novartis funding research and guideline panels. Investigations have exposed how drug makers influence doctors through sponsored education and biased studies, much like what happened with cholesterol-lowering statins. When statins hit the market, "normal" cholesterol levels dropped, putting more people on drugs despite minimal evidence they extend life. Hypertension has followed the same playbook.
The 2017 guideline change would add 31 million new patients to treatment rolls, many of them seniors who may not need medication. These drugs come with real risks: 20–40% of users report side effects like fatigue, dizziness, cough, or kidney damage, and a quarter stop taking them within nine months. In older adults, aggressive treatment can be devastating, yet the push continues. A 2007 study showed that cutting medications in seniors slashed mortality from 45% to 21%, suggesting over-medication is a serious problem. Big Pharma's influence ensures the focus stays on numbers, not patient well-being.
Instead of chasing arbitrary numbers, we should focus on what's really driving high blood pressure. Poor circulation, often tied to blood cell clumping or stiff arteries, can be improved naturally. For example, earthing, connecting the body to the Earth's electrical charge by walking barefoot, has lowered systolic pressure by up to 14% in small studies. Getting better sleep, managing stress, and eating foods like beets that boost nitric oxide, can help blood vessels relax. Exercise and weight loss often work for mild cases. Even salt, demonised for decades, isn't the villain it's made out to be; moderate sodium intake prevents fatigue and heart issues, and low salt diets can raise cardiovascular risks by 34%.
The myths around high blood pressure, that it always causes heart disease, that lower is always better, and that drugs are the only answer, have been fuelled by shifting guidelines and pharmaceutical greed. Doctors once allowed higher readings in seniors to protect against falls, confusion, and organ damage, but today's 120/70 target ignores these risks. Nearly 80% of older adults are now labelled hypertensive, often to their detriment. It's time to question these numbers and focus on root causes like poor circulation and lifestyle. Before starting lifelong medications, monitor your own blood pressure, explore natural solutions, and find a doctor who values your health over industry profits. True vitality comes from understanding your body, not chasing a number.
https://www.midwesterndoctor.com/p/unmasking-the-great-blood-pressure