Leaders in Pharmaceutical Business Intelligence (LPBI) Group

What Level of Blood Pressure (BP) should be Treated? Comments on the New Guidelines

Reporter: Aviva Lev-Ari, PhD, RN

UPDATED on 2/27/2018

ACC, AHA Fire Back at Charge of BP Guideline Conflicts

Open Payments system ‘replete with erroneous data’

by Crystal Phend,Senior Associate Editor, MedPage Today

February 14, 2018

“We remain completely convinced of the high value of the Hypertension Guideline for the long-term heart and brain health of the American public and have found nothing that would dispute the motives or actions of our distinguished volunteer authors. We have, however, noted areas where our processes could be improved and have modified them.”

Based on the Open Payments database, Romano had initially alleged that Kim Williams Sr., MD, of Rush University and past president of the ACC, who was on the guideline writing committee, “received $19,594 in 2015 and $20,000 in 2016 in grant funding from Boston Scientific. Boston Scientific sells a device called the Vessix renal denervation system to treat hypertension. He disclosed no relationship with Boston Scientific.”

https://www.medpagetoday.com/cardiology/hypertension/71158

ACC: 130/50 vs 140/90

Last year, the American Heart Association, the American College of Cardiology and many other cardiology organizations announced that the threshold for identifying hypertension had been officially lowered. The threshold for diagnosing and treating hypertension was now 130/80.

The document relies in part on the findings of the SPRINT trial, but no one really understands the blood pressures in that study. Strangely, the document applies its recommendations to people who were not even represented in the SPRINT trial. For example, it applies its recommendations to those with heart failure, even though there is no scientific basis for doing so.

Nevertheless, suddenly, 46% of Americans had hypertension. On the previous morning, 32% had the disease. Within 24 hours, millions of people were given a new label.

Furthermore, millions of people who thought they had well-controlled blood pressure (because it was below 140/90) now learned that they needed to do more to bring their blood pressures down.

In December, the American Academy of Family Physicians (AAFP) said they were not endorsing the new hypertension guideline.

American College of Physicians which proposed a target systolic blood pressure of 150 for people who were 60 years or older. Earlier this week, the ACP doubled down, issuing a statement criticizing the lower threshold.

The Fake Hypertension War – Medical politics and mud fights

by Milton Packer MD

January 24, 2018

https://www.medpagetoday.com/blogs/revolutionandrevelation/70716

Packer recently consulted for Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Cardiorentis, Daiichi Sankyo, Gilead, Novo Nordisk, Relypsa, Sanofi, Takeda, and ZS Pharma. He chairs the EMPEROR Executive Committee for trials of empagliflozin for the treatment of heart failure. He was previously the co-PI of the PARADIGM-HF trial and serves on the Steering Committee of the PARAGON-HF trial, but has no financial relationship with Novartis.