Life Extension Magazine®
Man monitoring blood pressure for better life expectancy

Add Five More Years with One Therapy

Huge numbers of heart attacks and strokes occur in those who fail to keep systolic blood pressure below 120-130 mmHg. One study shows total life expectancy to be 5 years longer in those who achieve optimal blood pressure control.

By William Faloon.

William Faloon
William Faloon

My 40-year quest to persuade supporters to keep their blood pressure in lower ranges continues to fail!

I’ll never forget a call I received from a dedicated Life Extension® supporter in the 1980s who had suffered an ischemic stroke.

He was fortunate to fully recover.

My first question was about his blood pressure. It was elevated.

This supporter recalled our warning to keep blood pressure below 120/80 mmHg. He nonetheless thought that his healthy diet and supplements protected against the effects of hypertension.

I instantly responded that we never implied that anything could protect the brain against the destructive impact of high blood pressure.

Despite my many articles and live presentations, I continue to interact with readers of this magazine who don’t optimize their blood pressure.

One study shows total life expectancy is five years longer in people with blood pressure below 120/80 mmHg compared to people at 140/90 mmHg and above.1

More recent data confirm the magnitude of heart attacks and strokes occurring in those who fail to target systolic blood pressure below 120-130 mmHg.

This editorial describes the lost life years that have occurred because of this single health issue and discusses how easy it is to take corrective actions.

Each time your heart beats, it generates systolic pressure that enables oxygenated blood to circulate throughout your body.

Normal aging usually results in elevation of systolic blood pressure that damages arteries and delicate capillary beds.

Excess systolic blood pressure causes or contributes to:2-5

  • Coronary artery disease
  • Aortic valve stenosis
  • Cerebral vascular disease
  • Kidney failure
  • Retinopathy and other eye disorders
  • Dementia

Blood pressure is increasing worldwide due to ever-growing numbers of overweight and obese individuals.

If effective medications were not available, I would not be as adamant in urging everyone to achieve optimal blood pressure readings.

To use a simple analogy, imagine the sprinkler head on your garden hose is turned to the “off” position.

Would your vinyl hose remain intact longer if there were a small amount of water pressure coming from the spigot or if the spigot were turned all the way up, meaning your vinyl hose would have to contain high water pressure?

I hope the answer is obvious, i.e., lower pressure inflicts less damage!

The Framingham Heart Study

Doctor holding screen heart

You may recall reading about the Framingham Heart Study but may not realize its significance.

Prior to Framingham, there were no strong and reliable data about heart attack and stroke prevention. This meant that doctors lacked the necessary evidence to optimally reduce the heart attack and stroke risk.

Findings from Framingham have averted hundreds of millions of cardiovascular events, yet the majority of the public overlooks these remarkable data sets.

Elevated blood pressure is a major modifiable risk factor for cardiovascular disease and mortality.6,7

According to a 2002 World Health Organization report, suboptimal blood pressure (defined as systolic blood pressure over 115 mmHg) was estimated to be responsible for 62% of cerebrovascular disease and 49% of coronary heart disease.8

The relationship between blood pressure and cardiovascular disease is well established.9

These data are consistent with our longstanding definition of optimal blood pressure of 115/75 mmHg.

Based on this, when systolic blood pressure is over 115 mmHg, this means it is suboptimal. Typical aging people often have systolic readings far above 140 mmHg.

Older people with preexisting vascular disease or circulatory deficits, however, often need higher systolic pressure (around 130 to 140 mmHg) to ensure adequate circulation to their brain and kidneys.10

The irony of this is that hypertension in early life damages capillary beds that then require higher-than-optimal systolic pressure to obtain adequate blood flow to critical organs (e.g. brain, kidneys).

Such higher systolic pressure—despite being necessary in these types of cases—also inflicts more vascular damage.

Impact of Blood Pressure on Lifespans

Doctor taking note of patient’s blood pressure

Although many past studies have attempted to estimate the impact of hypertension on heart attack and stroke risk, relatively few studies have looked at the impact of blood pressure on life expectancy.

In addition, the life expectancy effects of elevated blood pressure in people without cardiovascular disease was not well-studied in the past.

One of the first studies to estimate the relative impact of different blood pressure ranges/targets upon life expectancy used data from the Framingham Heart Study.1

The participants in this study were allocated in the following blood pressure groups:

  • Group 1: Blood pressure below 120/80 mmHg
  • Group 2: Systolic blood pressure between 120-139 mmHg
  • Group 3: Blood pressure over 140/90 mmHg

Average follow up was 27.5 years, which is an impressive amount of time for human studies.

There was an overall increase in risk of heart attacks and strokes in Group 2 (systolic blood pressure between 120-139 mmHg and Group 3 (blood pressure over 140/90 mmHg) compared to Group 1.

Significant increases in mortality (deaths) were observed in Group 3 (systolic over 140 mmHg), but not Group 1 and 2.

This is somewhat encouraging for those who require a higher systolic pressure of around 130 mmHg as there was not a significant overall mortality increase.

The life expectancy differences between Group 1 (below 120/80 mmHg), Group 2 (systolic 120-139 mmHg) and Group 3 (systolic over 140 mmHg), however, were substantial.

Compared to Group 1 (below 120/80 mmHg), Group 3 (over 140/90 mmHg) had a decrease in total life expectancy of about five years.

Group 2 (systolic pressure between 120-139 mmHg) had a decrease in total life expectancy that was about half as much as Group 3 (over 140 mmHg).

These observational data reveal the long-term damage inflicted by the higher blood pressure seen in Group 2 and Group 3 compared to Group 1 (systolic blood pressure below 120 mmHg).

A conclusion by the authors of this observational study is that blood pressure control should be initiated as soon as age 40.1

We at Life Extension have urged this for people of all ages (especially overweight and obese individuals) since elevated blood pressure in early life can inflict irreversible circulatory damage.

Confirmatory Results From 2017 and 2019 Studies

Nutritionist showing patient ways to reduce pressure

The study I just described was published in 2005 using Framingham data that were observational and had limitations.

More recent tightly controlled studies validate the risks of sub-optimal blood pressure control.

Findings published in 2017 led to massive changes in conventional guidelines. These new recommend-ations target systolic pressure below 120 mmHg in most people. This study was widely publicized and showed a 25% reduction in risk of cardiovascular events when systolic blood pressure is targeted below 120 mmHg.11

Studies presented at the American Heart Association’s annual meeting in November 2019 clarified some of these findings and suggest that additional years of life can be added with aggressive blood pressure control.11

According to the president of the American Heart Association:11

“... this analysis suggests that a 50-year-old person with systolic pressure under 120 mmHg could expect to live almost 3 years longer.”

By age 65, the lifespan increase in response to systolic pressure targeted below 120 was more than a year. The lifespan increase dropped to 10 months when optimal blood pressure control was not initiated until age 80.11

To put the findings in terms of their real-world significance, data from the Centers for Disease Control and Prevention show that nearly 1,300 Americans die each day with high blood pressure as a primary or contributing cause.12

This prompted our Life Extension® scientific team to estimate how many Americans may have needlessly died of hypertensive-related disorders since 1980 when LifeExtension® started publishing a health newsletter.

Unprecedented Human Carnage

Beginning around 1980, blood pressure levels and cardiovascular risks began to show that low normal was better.

In 2003 the cumulative data suggested that blood pressure guidelines needed to be lowered.

It was not until 2017 that Life Extension’s suggestions dating back to the early 1980s—(that optimal blood pressure is below 120/80 mmHg)—were formally implemented in standard clinical practice.13

To roughly estimate how many lost American “life years” occurred because of this delay in lowering blood pressure guidelines, Life Extension’s scientific staff amalgamated relevant published data beginning in the year 1980.

Here is the Executive Summary of our findings:

“On the basis of the available scientific evidence, we can roughly estimate years of life lost attributable to hypertension. From the data we were able to collect and analyze, we estimate that approximately 37,712,740 years of life may have been lost between 1980 and 2014 due to hypertension as an underlying cause in adults aged 45 to 85+ years.”

In case the number is confusing, assume that each person who died from less-than-optimal blood pressure between 1980 and 2014 lost on average five years of life. This prompts us to estimate that roughly 37 million years of life were needlessly lost from hypertensive-related causes during this 34-year period (1980-2014).

If you cut our estimate by 80%, it still comes to over seven million years of life lost due to hypertension.

Findings from the studies described in this editorial provide stark evidence of why you need to look beyond conventional medicine guidelines when seeking to extend your healthy longevity.

And what I like so much nowadays is that you can type into Google or www.pubmed.gov search terms like “hypertension and mortality risk” and read the scientific reports yourself.

Refocusing Priorities

Man taking blood pressure with doctor on call

In today’s soundbite media world, a catastrophic event involving the death of as little as ONE person generates headline news.

Meanwhile, over 1,600 American cancer patients perish every day and even more suffer and die from cardiovascular disorders.14,15

My perturbation about excess media coverage of these rare catastrophic occurrences is that it distracts from what needs to be done to address the 5,000 Americans dying each day from degenerative diseases of aging.

A Solution to the Hypertension Crisis

The prevalence and severity of today’s hypertension crisis cannot be overstated. Too many people over ages 65 and 75 have dangerously elevated systolic blood pressure.

Yet drugs that can safely drop blood pressure into safer ranges are grossly underutilized.

At-home blood pressure monitors are accurate and inexpensive. They allow for far more careful and precise monitoring of blood pressure than visiting a doctor several times a year.

That’s because blood pressure readings vary dramatically in response to a range of factors such as time of day or night, stress levels, and various other routine circumstances. By checking one’s blood pressure at home, one can identify when systolic “spikes” are occurring and adjust their anti-hypertensive drug intake, in consultation with a medical professional.

Physician Assistants and Nurse Practitioners

More physician assistants and nurse practitioners should be on the front lines in curbing the epidemic of hypertension plaguing older and overweight individuals.

Under this scenario, you would bring a history of your at-home blood pressure readings to a physician’s assistant or nurse practitioner, who can then prescribe low doses of drugs like telmisartan, an angiotensin receptor blocker (ARB) drug, a beta-blocker like carvedilol, and/or a diuretic.

Following the advice of this medical professional, you would begin taking the prescribed low doses of these drugs and continue monitoring your blood pressure.

If this approach failed to lower your blood pressure to optimal levels (115/75 mmHg), your medical professional could adjust the dose of anti-hypertensive medication.

Under this scenario, those who don’t like going to doctors could monitor themselves, keeping records of blood pressure readings at various times of the day and bring the reports to a physician assistant or nurse practitioner so that other low-dose anti-hypertensive drugs could be tried, and thus achieve improved blood pressure control.

This could also be accomplished via convenient telemedicine conferences with the medical professional. The net effect would reduce medical outlays and improve patient outcomes.

Contrast the cost-effective scenario I propose to one in which people have an annual exam, one blood pressure reading, are prescribed one dose of one drug and then wait another 3-12 months to reevaluate.

Empowering patients to take control of their own blood pressure could spare millions of Americans each year from the multitude of diseases that hypertension silently inflicts.

Easy Ways to Lower Blood Pressure

The risks posed by even modest blood pressure spikes were long ago quantified. Yet too many aging and obese Americans have dangerously high blood pressure.

Nutrients (like garlic,16-19 melatonin,20-22 and fish oil23-25) can lower systolic pressure a few points, but most hypertensives need to either lose weight and/or take drugs, some that have side benefits.

A common drug class used to reduce blood pressure are beta-blockers. The beta-blocker drug carvedilol has been associated with lower cancer risk in some studies.26-29

A drug called telmisartan is a different class of medication that has been shown to improve endothelial function, in addition to reducing stubbornly high blood pressure.30-33

Please initiate measures to bring your blood pressure into optimal ranges.

I hope to reach a point where no supporter suffers a hypertensive-related disorder that was easily preventable.

For longer life,

For Longer Life

William Faloon

References

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  2. Flint AC, Conell C, Ren X, et al. Effect of Systolic and Diastolic Blood Pressure on Cardiovascular Outcomes. N Engl J Med. 2019 Jul 18;381(3):243-51.
  3. Rapsomaniki E, Timmis A, George J, et al. Blood pressure and incidence of twelve cardiovascular diseases: lifetime risks, healthy life-years lost, and age-specific associations in 1.25 million people. Lancet. 2014 May 31;383(9932):1899-911.
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  5. Available at: https://www.niddk.nih.gov/health-information/kidney-disease/high-blood-pressure. Accessed August 26, 2020.
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