Lowering the drug threshold for high blood pressure treatment has exposed millions of low-risk people to drugs that may not benefit them and expose health systems to huge costs, a US expert claims today.
Writing in The BMJ today, Dr Stephen Martin, assistant professor at the Department of Family Medicine and Community Health, University of Massachusetts Medical School MA, warns that the strategy is not only failing patients, but is also wasting healthcare resources.
Dr Martin and colleagues reveal their concerns in a paper at the Preventing Overdiagnosis conference, which will discuss how to tackle the threat to health and the waste of money caused by unnecessary care, opens today.
In their paper, they call for a re-examination of the threshold and say that clinicians should be more cautious about treating low risk patients with blood pressure lowering drugs.
Over the years, the blood pressure threshold to treat hypertension has become progressively lower in the belief that drug treatment of even mildly raised blood pressure levels in low risk patients may reduce the risk of heart problems.
Even though more than half of people with mild hypertension are treated with medication, it has not been proven to reduce heart disease or death.
In the US alone, the cost of drug treatment of mild hypertension has been estimated at $32 billion (£19bn; €24bn) per year – more than 1% of annual healthcare costs.
Dr Martin says that the increased drug treatment “risks adverse effects, such as increased risk of falls, and misses opportunities to modify individual lifestyle choices and tackle lifestyle factors at a public health level”.
Instead, patients should be encouraged to make lifestyle changes, including weight loss, smoking cessation, decreased alcohol consumption and increased exercise.”
Martin SA et al. Mild hypertension in people at low risk. BMJ 15 September 2014;349:g5432. doi: 10.1136/bmj.g5432 [abstract]
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