Lowering definition of high blood pressure ‘may make condition worse’

Scientists warn reducing official threshold could cause patients stress that increases hypertension

PROPOSALS to redefine “high blood pressure” and offer more patients medication could increase the risk of the condition, a report suggests.

The National Institute for Health and Care Excellence (Nice) is currently considering evidence that has led the US to change its advice, making millions more patients eligible for daily drugs to cut their heart attack risk.

The criteria could mean almost half of Britons become eligible for drugs to reduce their blood pressure.

But a report by the University of Sydney says such changes could put lives at risk – partly because a diagnosis of high blood pressure is likely to increase anxiety levels. Episodes of anxiety and stress can cause spikes in blood pressure. Other patients could see an increased risk from side-effects of medication, without a reduction in their risk of heart disease, the findings suggest.

Currently, around seven million Britons whose blood pressure exceeds 140/90 are recommended to take medication, with higher limits set for patients over 80.

The drugs, which cost the NHS as little as 10p a day, are normally recommended for patients deemed to have a 20 per cent risk of heart disease or stroke within the decade.

But the guidelines published by the American Heart Association brings the systolic threshold down to 130/80, which is estimated to mean a 10 per cent chance of those same conditions occurring over the same period.

The recommendations follow US trials that found that aggressively lowering the targets for blood pressure could reduce the risk of death among people over 50 by almost one quarter. Nice is considering the same evidence, alongside other trials, such as one by Oxford University which found similar benefits. The watchdog is due to publish its new advice next year.

Medication includes ACE inhibitors, angiotensin-2 receptor blockers (ARBS), calcium channel blockers, diuretics and beta-blockers.

Most patients take at least two types of pills, but more aggressive targets could increase the number of different drugs recommended.

However, the latest study suggests other risks from a diagnosis of high blood pressure, and subsequent treatment, have not been properly considered.

Dr Katy Bell said: “Labelling a person as having hypertension increases their risk of anxiety and depression, as compared to the risk for people with the same blood pressure who aren’t labelled as hypertensive.

“Second, it means more people may experience serious adverse effects from treatments.”