Menu

Location

Making Sense of Guidelines for Care

Not too long ago, the Eighth Joint National Committee (originally commissioned by the National Heart, Lung, and Blood Institute) released a new set of evidence-based guidelines for evaluation and treatment of hypertension (high blood pressure). The guidelines committee, comprised of 17 academics, spent five years reviewing evidence as preparation for developing the new recommendations.

The committee’s report represents nothing less than a sea change in the treatment of patients with higher-than-normal blood pressure readings. The primary shift is from a long-held standard of implementing treatment when a person’s blood pressure is higher than 140/90 mmHg. The new guidelines recommend beginning treatment only when blood pressure readings are higher than 150/90 mmHg. The new standard is a huge modification of decades-old practice methods, and has generated substantial controversy.1.2 Of course, a good portion of the pushback is from those who have a vested interest in maintaining the status quo, such as physicians who dispense medications from their office and earn substantial income from selling antihypertensive drugs at multiples of their wholesale costs. In addition to physicians who act as pharmacies, drug companies who manufacture antihypertensive medications also stand to lose significant revenue. But aside from considerations related to the practice of medicine as a business, the real issues should be focused on the benefits and harms to patients. In this context, it may be reasonably stated that fewer medications are, by and large, a good thing.

The new blood pressure guidelines have two primary impacts. First, for people over age 60, treatment for presumed hypertension should be initiated when blood pressure readings are higher than 150/90 mm/Hg. More than 7.4 million Americans over age 60 will be in the new safe range. Many of these millions of people have been taking antihypertensive medication for years, possibly needlessly as implied by the new guidelines. Next, for all those under age 60, there is insufficient medical evidence that a systolic blood pressure (the first number in the reading) threshold exists that would dictate treatment. In other words, for many years the systolic threshold had been 140 (as in 140/90 mmHg). Higher systolic readings virtually mandated antihypertensive treatment. Although the committee expressed its opinion that the systolic threshold of 140 mmHg ought to be maintained for those younger than age 60, even though evidence for such a threshold is weak. Thus, it may be that many millions more people have been taking antihypertensive medication without such recommendations being backed by sound scientific research.

The point here is not that people should stop taking their blood pressure medication.3 All such types of decisions should be made in consultation with the prescribing physician. The main consideration is having the ability to make informed choices. Some medication regimens may be appropriate. Some may not. Some may need to be reevaluated. As always, regular chiropractic care is of value by providing you with the best opportunity to achieve maximum good health.

1Mitka M:Groups spar over new hypertension guidelines. JAMA 311(7):663-664, 2014
2Kieldsen SE, et al: Hypertension management by practice guidelines. Blood Press 23(1):1-2, 2014
3Sheppard JP, et al: Missed opportunities in prevention of cardiovascular disease in primary care: a cross-sectional study. Br J Pract 2014, Jan;64(618):e38-46. doi: 10.3399/bjgp14X676447

Location

Find us on the map

Office Hours

Our Regular Schedule

Monday:

8:00 am-10:00 am

2:00 pm-6:00 pm

Tuesday:

2:00 pm-6:00 pm

Wednesday:

8:00 am-10:00 am

2:00 pm-6:00 pm

Thursday:

8:00 am-10:00 am

2:00 pm-6:00 pm

Friday:

Closed

Saturday:

Closed

Sunday:

Closed

Testimonials

Reviews By Our Satisfied Patients

  • "I love it there so polite and right to the point never pushy or rude vet respectful. I wouldn’t go anyplace else. Love them all!!"
    Kandice Desalvo V.
  • "Dr. Ho and Dr. Q are caring and compassionate doctors. Their goal is to make you feel great. They take the time to listen to your concerns and address them. I would definitely recommend these doctors!"
    Sandra E.
  • "I got refer from a Dear good friend Jennifer which ive been having problems with my neck n knees. I would definitely recommend Pinnacle Wellness they have a great friendly staff n Doctors are great! I've learned a lot about our bodies n etc. I will continue seeing them again !!! My adjustments are great!"
    Cynthia T.
  • "We have been going to Pinnacle Wellness for over 3 months now, back pain has stopped 100%. We are still blown away by how amazing Dr. Q and Dr. Ho are. We are blessed they came into our lives and have truly added so much to our knowledge about our bodies and even personal growth and development. Pinnacle Wellness is nothing short of a breath of fresh air. Isabelle at the front desk always makes our day. If you are looking for a chiropractor that truly cares for your well being, my family would definitely recommend you to look no further and make Pinnacle Wellness your destination. I had just learned to live with and accept my daily back pain. Thanks to Pinnacle Wellness our lives have been forever changed and look forward to seeing the happy faces of the staff and will be enjoying a pain free life thanks to our journey with Pinnacle Wellness."
    Cara C.
  • "If you have back and/or neck trouble and have never been to a chiropractor before, then this is the place for you. I was referred here by my wife who has been seeing the doctors for several years. Since starting my adjustments I sleep better and feel better all around, and no it doesn't hurt. Currently I am recovering from tennis elbow and bursitis which the doctors are helping me recover by using a massager on my arm when I visit, even my physical therapist was glad they were helping out."
    Royce S.
  • "I have been a patient of Pinnacle Wellness for many years. They have a great, friendly staff and Doctors who truly care about there patients. I would recommend this place to anyone with back or neck pain."
    James S.
  • "The staff is extremely friendly and personable when you enter the facility. They make you feel like you are a part of the family. Our kiddos get adjusted too and for our infant it helped him to crawl properly when he was having difficulties or crawling abnormally. It is a vital part of our healthiness and we would recommend them to everyone!"
    Jennifer C.