Comment on It's not that bad quit whining
Apytele@sh.itjust.works 5 days agoYeah this very much depends on the actual specific number. I work inpatient so I don’t blink at 155 systolic because we’re gonna take it again in 12h and honestly these days the hospitalist says current evidence supports not even treating emergently until 170. 140s to me is a GP/PCP’s problem 3 months from now and 130s they’ll probably just tell the person to eat less salt. There’s also the possibility that the doctor just figured she wouldn’t take anything anyway based on this person’s description.
Zorcron@lemmy.zip 5 days ago
No seriously, there is no number that you treat emergently without accompanying signs of end-organ damage. The AHA recommends considering “permissive hypertension” even for SBPs over 180. So you could be 220/180 and if no other symptoms or signs of organ damage, you get treated the same as someone who is 145/95, and even then that’s only if the hypertension is chronic. The only difference is it will probably take a lot more meds to chronically control someone whose bp is that extreme.
AHA’s 2024 review article for reference
BarrelAgedBoredom@lemmy.zip 5 days ago
Zorcron@lemmy.zip 5 days ago
Yeah >180 is definitely serious, I may have overstated myself there trying to make my point. If you read that high, it’s recommended to contact your doctor asap, but not to seek emergency treatment unless you’re having symptoms.
Current (but limited) evidence actually suggests some harm caused by unnecessarily treating asymptomatic markedly elevated blood pressure, and low risk of acute (hours to days) adverse events caused directly by the hypertension.
I’m a PharmD who works in the ED at a large teaching hospital. I have this conversation often.
Recommendations from the AHA directly to patients/lay persons
A great “Things We Do For No Reason” article about the topic. (There’s even one article in this paper that specifically talks about patients with systolic >220, only 0.2% of which had a negative vascular outcome at 7 days without inpatient treatment.) I highly recommend this paper. The folks at SHM/JHM do great work with this series.
Valmond@lemmy.dbzer0.com 4 days ago
Thanks for sharing, always so nice when people who actually know what they are talking about chips in!