Blood Pressure: Early On Handling Advised Yesteryear Us Guidelines Has No Survival Benefits Technica
Sunday, November 3, 2019
Edit
When is high blood force per unit of measurement area dangerous? Medical associations offering widely differing answers. In the USA, for example, patients are seen equally hypertensive much sooner than inward Germany. Influenza A virus subtype H5N1 squad working amongst Prof. Karl-Heinz Ladwig of the Technical University of Munich in addition to the Helmholtz Zentrum München has concluded that treating patients sooner does non trim down the run a jeopardy of deadly pump disease. It could fifty-fifty negatively ship upon their mental health.
In 2017 the American College of Cardiology added a novel category to its guidelines for high blood pressure: "Stage 1 Hypertension". Under the novel standards, doctors are advised to house patients inward this category (130-139 mmHg / 80-89 mmHg) on treatment. For the European Society of Cardiology, that gain is defined equally "high normal" blood pressure, amongst no specific activity recommended.
"The persuasion behind the U.S. of America guidelines is to lower blood force per unit of measurement area equally early on equally possible and, yesteryear presenting patients amongst a diagnosis, to encourage them to adopt a healthier lifestyle," explains Prof. Karl-Heinz Ladwig, a researcher at the Clinic for Psychosomatic Medicine in addition to Psychotherapy at the TUM University Clinic rechts der Isar at the Helmholtz Zentrum München.
Motivation constituent questionable
Using information from unopen to 12,000 patients, Ladwig in addition to his squad assessed the province of affairs inward Germany. "We studied the 10-year run a jeopardy of mortality from cardio-vascular illness (CVD) amid people inward the diverse hypertension categories inward the context of the other run a jeopardy factors affecting them," says Seryan Atasoy, the get-go writer of the study, who is working equally an epidemiologist at Helmholtz Zentrum München in addition to Ludwig-Maximilians-Universität München.
In the newly created category "Stage 1 Hypertension", the CVD mortality run a jeopardy was non significantly higher than amid patients amongst normal blood pressure. "The motivation effect is questionable, too," says Karl-Heinz Ladwig. Patients inward the high-risk category "Stage ii Hypertension", where medication is recommended nether both the U.S. of America in addition to the European guidelines, stimulate got a much greater run a jeopardy of dying of pump disease, he explains. "At the same time, run a jeopardy factors such equally smoking in addition to a lack of do are far to a greater extent than frequent inward that group. That shows that many people produce non modify their lifestyles despite the diagnosis."
Dangerous depression Although the incidence of depression is to a greater extent than frequently than non lower amid people amongst dangerously high blood force per unit of measurement area than inward the full general population, depression was significantly to a greater extent than mutual inward i subset of that group: those taking medication to process their serious hypertension. Here, depressive moods were reported yesteryear around one-half of all patients, equally opposed to simply one-third of those non receiving treatment.
"We believe that this should hold upward seen equally a labeling effect," says Ladwig. "When people are officially labeled equally 'sick', that has an impact on their mental health." Influenza A virus subtype H5N1 previous study yesteryear Ladwig in addition to his squad showed that, inward damage of mortality run a jeopardy from cardio-vascular disease, depression is comparable to high cholesterol levels or obesity.
New guidelines hateful to a greater extent than sick people "The American College of Cardiology itself has calculated that the proportion of adults diagnosed amongst high blood force per unit of measurement area volition growth from 32 to 46 percent," says Karl-Heinz Ladwig. "That agency fourteen per centum to a greater extent than who stimulate got to bargain amongst the additional mental stress - although their run a jeopardy of developing a potentially deadly cardio-vascular status is non significantly higher, in addition to despite no existent expectation of extra motivation through the diagnosis." For those reasons, Ladwig believes that it would hold upward a serious error to adopt the U.S. of America guidelines inward Europe.
Contact: Prof. Dr. Karl-Heinz Ladwig
Technical University of Munich (TUM)
Klinikum rechts der Isar
Clinic for Psychosomatic Medicine in addition to Psychotherapy
+49 89 3187 3623
Email: ladwig@helmholtz-muenchen.de
In 2017 the American College of Cardiology added a novel category to its guidelines for high blood pressure: "Stage 1 Hypertension". Under the novel standards, doctors are advised to house patients inward this category (130-139 mmHg / 80-89 mmHg) on treatment. For the European Society of Cardiology, that gain is defined equally "high normal" blood pressure, amongst no specific activity recommended.
"The persuasion behind the U.S. of America guidelines is to lower blood force per unit of measurement area equally early on equally possible and, yesteryear presenting patients amongst a diagnosis, to encourage them to adopt a healthier lifestyle," explains Prof. Karl-Heinz Ladwig, a researcher at the Clinic for Psychosomatic Medicine in addition to Psychotherapy at the TUM University Clinic rechts der Isar at the Helmholtz Zentrum München.
Motivation constituent questionable
Using information from unopen to 12,000 patients, Ladwig in addition to his squad assessed the province of affairs inward Germany. "We studied the 10-year run a jeopardy of mortality from cardio-vascular illness (CVD) amid people inward the diverse hypertension categories inward the context of the other run a jeopardy factors affecting them," says Seryan Atasoy, the get-go writer of the study, who is working equally an epidemiologist at Helmholtz Zentrum München in addition to Ludwig-Maximilians-Universität München.
In the newly created category "Stage 1 Hypertension", the CVD mortality run a jeopardy was non significantly higher than amid patients amongst normal blood pressure. "The motivation effect is questionable, too," says Karl-Heinz Ladwig. Patients inward the high-risk category "Stage ii Hypertension", where medication is recommended nether both the U.S. of America in addition to the European guidelines, stimulate got a much greater run a jeopardy of dying of pump disease, he explains. "At the same time, run a jeopardy factors such equally smoking in addition to a lack of do are far to a greater extent than frequent inward that group. That shows that many people produce non modify their lifestyles despite the diagnosis."
Dangerous depression Although the incidence of depression is to a greater extent than frequently than non lower amid people amongst dangerously high blood force per unit of measurement area than inward the full general population, depression was significantly to a greater extent than mutual inward i subset of that group: those taking medication to process their serious hypertension. Here, depressive moods were reported yesteryear around one-half of all patients, equally opposed to simply one-third of those non receiving treatment.
"We believe that this should hold upward seen equally a labeling effect," says Ladwig. "When people are officially labeled equally 'sick', that has an impact on their mental health." Influenza A virus subtype H5N1 previous study yesteryear Ladwig in addition to his squad showed that, inward damage of mortality run a jeopardy from cardio-vascular disease, depression is comparable to high cholesterol levels or obesity.
New guidelines hateful to a greater extent than sick people "The American College of Cardiology itself has calculated that the proportion of adults diagnosed amongst high blood force per unit of measurement area volition growth from 32 to 46 percent," says Karl-Heinz Ladwig. "That agency fourteen per centum to a greater extent than who stimulate got to bargain amongst the additional mental stress - although their run a jeopardy of developing a potentially deadly cardio-vascular status is non significantly higher, in addition to despite no existent expectation of extra motivation through the diagnosis." For those reasons, Ladwig believes that it would hold upward a serious error to adopt the U.S. of America guidelines inward Europe.
###
Publication: S. Atasoy, H. Johar, A. Peters, K.-H. Ladwig. "Association of hypertension cut-off values amongst 10-year cardiovascular mortality in addition to clinical consequences: a real-world perspective from the prospective MONICA/KORA study". European Heart Journal (2018). DOI:10.1093/eurheartj/ehy694 Contact: Prof. Dr. Karl-Heinz Ladwig
Technical University of Munich (TUM)
Klinikum rechts der Isar
Clinic for Psychosomatic Medicine in addition to Psychotherapy
+49 89 3187 3623
Email: ladwig@helmholtz-muenchen.de