Aggressive control of blood pressure has saved millions of lives and has prevented millions of people from experiencing heart attacks, strokes, and kidney failure, among other things. Admittedly, controlling blood pressure is not the sexy part of medical care, but when primary care doctors like me help people get their blood pressure under control, we do just as much good as any of our colleagues who practice as cardiovascular surgeons. (No offense to those surgeons, of course, who do worlds of good for their patients!)
But blood pressure reduction can be too much of a good thing. For example, when patients with diabetes receive overly aggressive blood pressure treatment, the harms of that treatment — the side effects of low blood pressure — loom larger than the potential benefits.
And I’m not talking just side effects like feeling a little bit fatigued from taking the pill. Aggressive blood pressure treatment can increase the risk of hazardous falls, for example. Consequently, physicians sometimes need to take their foot off the gas and reduce the intensity of patients’ blood pressure medications.
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