Image copyright Getty Images Image caption Almost 9 million adults in the US take high blood pressure drugs
Nearly a fifth of adults in the US (19%) are taking medications that are not proving effective or do not reduce blood pressure, according to data from a large study in the Journal of the American Medical Association (JAMA).
As many as 11 million adults in the US were prescribed medication in 2014 – about 5% of the total population.
“This study provides further evidence that lifestyle interventions are necessary to achieve cardiovascular health in the United States,” it concluded.
In an editorial in the same journal, both authors pointed out that addressing obesity, related risk factors such as a high body mass index (BMI) or use of tobacco were equally as crucial as lifestyle changes.
“The data suggest that adding medication to lifestyle interventions may be ineffective and should be a last resort,” said Dr David Ludwig, one of the authors of the editorial.
American Heart Association President Robert Stulen said in a statement: “The current findings reinforce the importance of referring patients who experience symptoms of elevated blood pressure to high blood pressure treatment specialists and treatment options.
“The term ‘hypertension’ can be misleading, since elevation of pressure is typically found in association with a number of other risk factors such as obesity, high blood pressure and smoking. “
As in previous studies, this one showed that people who were obese, were very sedentary or smoked more than 15 cigarettes a day had the highest levels of blood pressure readings.
However, it showed that lifestyle changes could influence blood pressure to some extent, particularly among those who met other health guidelines.
Image copyright Reuters Image caption Dr David Ludwig, one of the authors of the editorial in JAMA, stressed lifestyle changes needed to be equally as important as taking medication
People who had regular physical activity, took at least 600mg of aspirin per day, experienced a normal body mass index (BMI) or hypertension were less likely to have blood pressure medications.
Their blood pressure was higher than people who lived with a normal BMI but did not engage in any other lifestyle modifications.
Among those who had poor levels of lifestyle and medical behaviours, half were prescribed medications, with high blood pressure drugs being the most common.
Among the group who were actively taking medication, 61% got blood pressure treatment, with many as many as 60% taking two blood pressure medication.
“Eating less salt and eating less saturated fat and cholesterol may be easier than changing your lifestyle and how you eat,” said Dr Mike Davis, a professor of medicine at the University of Virginia.
“The study notes that a person can only take 20% of the number of pills prescribed.
“Patients should be seeking out doctors who provide high blood pressure tests that can predict how their own numbers will change over time,” he said.
Who should be targeted?
Image copyright Getty Images Image caption Those in America with a high BMI were most at risk of being prescribed medication
Some of the data used in the JAMA study was available from studies going back to the 1960s and considered current with three kinds of medication and lifestyle interventions.
However, this research – which included one of the largest studies in people’s lifestyles – was held back from 2009 to 2014 because of safety concerns.
However, in other longitudinal studies, such as a 2011 CDC (Centers for Disease Control and Prevention) study in 24,000 Americans, the medication versus lifestyle therapies were found to be only slightly different between whites and African Americans.
And a Johns Hopkins study from 2015 found that 16% of African Americans were prescribed the wrong medication for their blood pressure.
Blood pressure medicine may raise the risk of side effects. In some cases, some patients may opt for lifestyle changes or are lucky enough to see the benefits of medications sooner.
But in the case of others, whether they choose lifestyle changes or medication, should be strongly considered.