Blood Pressure Treatment Linked to More Disease

What you eat and drink, how much exercise you get and even how you breathe every day has a compound effect on your overall health. Making even small changes to your lifestyle can pay big dividends in the coming months and years. The same is true of the small decisions you make that aren't healthy. One soda in your lifetime doesn't have an effect, whereas several sodas a week have a significantly detrimental effect.

The choices you make also affect your blood pressure measurements, and therefore your potential risk for heart disease and stroke. According to the U.S. Centers for Disease Control and Prevention (CDC), 1 in 3 American adults, or 75 million people, have high blood pressure.1 The total cost associated with treatment is over $46 billion in hospitalizations, medications and missed days at work.

A recent announcement by the American Heart Association (AHA) concerning guidelines for diagnosis of high blood pressure, also known as hypertension, could mean that nearly half of Americans may be classified with high blood pressure.2 Treatment for hypertension often involves a prescription that may raise your risk of cancer.3 

Common Hypertension Medication May Increase Your Risk of Cancer

A recent Danish study, in collaboration with Florida State University, found that one of the most popular drugs used worldwide to treat high blood pressure raises your risk of skin cancer seven times. The findings were published in the Journal of the American Association of Dermatology4 by researchers who had previously found a link between the drug hydrochlorothiazide and lip cancer.

In this study, they demonstrated an association between the medication and squamous cell and basal cell carcinomas, forms of less invasive skin cancer.5

The researchers have also looked at other antihypertensive medications but have not found an association between those and skin cancer.6 Anton Pottegard, Ph.D., associate professor from the University of Southern Denmark, initiated the study. He commented on what prompted the analysis of the potential link between hydrochlorothiazide and skin cancer, saying:

"We knew that hydrochlorothiazide made the skin more vulnerable to damage from the sun's UV rays, but what is new and also surprising is that long-term use of this blood pressure medicine leads to such a significant increase in the risk of skin cancer."

The study was based on data from national databases that followed 80,000 cases of non-melanoma skin cancer and compared it to 1.5 million healthy control subjects. Past research demonstrated the medication increased the vulnerability of the skin to the sun, but the researchers stated they were surprised this vulnerability led to such an increased risk of cancer.

Co-author of the study, Dr. Armand B. Cognetta Jr., from Florida State University, has found similar results in patients he treats in Florida, where "the only risk factor, apart from exposure to the sunlight, seems to be hydrochlorothiazide."7 Squamous cell carcinoma has a low mortality rate, but the treatments carry a risk of impairment and the potential the cancer will spread.8 The researchers are continuing to work on additional studies that may shed more light on these risks, which Pottengard acknowledges, saying:9

"The risk of skin cancer must, of course, be weighed against the fact that hydrochlorothiazide is an effective and otherwise safe treatment for most patients. Nevertheless, our results should lead to a reconsideration of the use of hydrochlorothiazide. Hopefully, with this study, we can contribute toward ensuring safer treatment of high blood pressure in the future."

How Your Blood Pressure Is Taken May Affect the Measurement

The technique your doctor or nurse uses to measure your blood pressure may have an effect on the reading. The current method of measuring blood pressure was invented in 1881 and refined in 1905.10 Today, the machine that measures blood pressure continues to measure the appearance and disappearance of sounds in the arteries, known as Korotkoff sounds, as the measurement standard.

Measurements taken at your doctor's office use the brachial artery in your upper arm or your femoral artery in your thigh. However, central aortic blood pressure (CBP) is considered a better marker of cardiovascular disease11 and a better indicator of the pressure your internal organs experience.12 Unfortunately, CBP requires an invasive procedure to determine the measurement.

Since a large deviation between CBP and peripheral (arm or leg) measurement can affect the decision to treat hypertension or direct the prescription of medication, researchers undertook a study13 to compare the differences and found that peripheral measurements were reasonably accurate when compared against CBP in those who had blood pressure lower than 120/80 or higher than 160/100.

At these extreme ends the accuracy was up to 80 percent. However, in the mid-range, the accuracy dropped dramatically to between 50 percent and 57 percent.14 Inaccuracies in blood pressure measurement may be associated with several factors you can control at your doctor's office and which I discuss in my previous article, "Blood Pressure Testing Is Mostly Inaccurate."

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