Showing posts with label blood pressure. Show all posts
Showing posts with label blood pressure. Show all posts

Are We Overmedicating Seniors? A Wake-Up Call for Those Over 60 on Blood Pressure Pills

 

By Munaeem Jamal

With insights from Dr. Suneel Dhand and contributions by Dr. Fareha Jamal (PharmD, BioNTech Researcher) and Maryam Jamal (5th Year Medical Student)




It started with a feeling.
A little dizziness after breakfast.
Some weakness in the knees.
Then one morning, an alarming reading: blood pressure in the 70s .

That's what happened to someone close to Dr. Suneel Dhand—a practicing US physician—who later realized that this elderly family member was overmedicated. And he's not alone.

Millions of older adults might be taking more blood pressure medication than they need , often unknowingly.


"It's a scandal," Dr. Dhand says. And he's right.

In a recent video that's caught quiet fire online, Dr. Suneel Dhand warns that far too many people over 60 are prescribed multiple blood pressure medications—sometimes 3 or 4 at a time—without proper follow-up. And often for decades.

"I see it every day in the hospital. It's everywhere. We treat aggressively—but we rarely reassess," says Dr. Dhand.

The problem? A blood pressure that's too low can be just as dangerous as one that's too high. Symptoms like:

  • Dizziness

  • Fainting

  • Confusion

  • Increased fall risk
    can all stem from excessively low systolic pressure , especially under 100.

And yet, many patients continue taking the same medications without reevaluation , even as their bodies age, their lifestyles change, or their diet improves.


The Most Common Cause Isn't Even Mentioned

Dr. Dhand, backed by years of clinical experience, points to insulin resistance —not just aging—as the hidden culprit behind high blood pressure.

That rings true for my daughter Dr. Fareha Jamal , a research scientist at BioNTech in Munich. She agrees:

"Insulin resistance is grossly underdiagnosed in older populations, especially in South Asia. Many patients can reduce their blood pressure by fixing their metabolic health—cutting sugar, losing visceral fat, walking more. But instead, they get prescriptions."

My younger daughter Maryam , a final-year medical student, adds:

"We're taught in med school to treat based on guidelines, but the guidelines aren't always patient-specific. Seniors aren't all the same. A 78-year-old who walks daily and eats clean might need less medication than someone sedentary."


So What Should You Actually Do?

If you're over 60 (like me), or you have a parent in their 70s or 80s taking multiple BP meds, here's a simple checklist based on Dr. Dhand's advice and my daughters' input:

Never stop medications abruptly — Always consult your doctor.

Buy a home BP monitor — A reliable one costs around $25–$35.

Record BP 3 times a day — Morning, afternoon, and evening, for 14 days.

Take your readings to the doctor — And take your device too. Match office readings with your own.

Watch for “too low” signs — Like dizziness, lightheadedness, or blurred vision, especially when standing.

Ask: Can we try tapering? — If your readings are consistently below 120/80, or you're feeling weak, it's time for a conversation.

“We should treat based on symptoms, not just numbers,” says Dr. Dhand.


The Bigger Problem: A Broken System

Why does this happen in the first place?

Because we treat blood pressure like a “set it and forget it” diagnosis. Pills are added. Rarely removed. The follow-up is inconsistent. And primary care is overstretched.

Even Dr. Dhand admits:

"There's a medical-industrial complex. More prescriptions mean more profit. And overaggressive treatment is now the norm."


What Happened to My Family Member

That loved one I mentioned earlier?
Once we flagged his low pressure, the doctor cut back one medication. The result?

His systolic pressure returned to normal. His energy improved. His dizziness vanished.

It wasn't magic.
It was monitoring, curiosity, and an honest conversation.


Final Thought

If you're over 60, or love someone who is, here's the question:

Are you still on medications that your body no longer needs?

Because aging isn't a diagnosis. It's a process. And like any process, it changes with time. So should our medications.

Credit:
Original insights from Dr. Suneel DhandWatch his video here
Expert opinions from Dr. Fareha Jamal and Maryam Jamal
Words by Munaeem Jamal

Vascular Dementia: The Brain Disease That Begins in Your Blood Vessels

Elderly man walking in a park with brain blood vessel illustration showing vascular dementia and the importance of heart health for brain protection
Vascular dementia develops when reduced blood flow damages brain cells. Managing blood pressure, diabetes, and cholesterol can help slow the risk.


Vascular dementia develops when reduced blood flow damages brain cells. It is the second most common form of dementia, yet many people do not realize that its roots lie in everyday health conditions such as high blood pressure, diabetes, and high cholesterol.

Unlike Alzheimer’s disease, vascular dementia is often preventable. In many cases, the damage begins years before memory problems appear.


What Causes Vascular Dementia?

The condition occurs when blood vessels that supply the brain become narrowed, blocked, or damaged. Common causes include:

  • Small vessel disease – narrowing of tiny arteries deep in the brain

  • Stroke – a major interruption of blood flow

  • Repeated mini-strokes – small injuries that accumulate over time

Many patients show both vascular damage and Alzheimer’s-related changes. This condition is known as mixed dementia.

Information gain insight: Brain imaging studies show that small vessel damage can develop silently for 10–20 years before symptoms appear.


Early Symptoms People Often Miss

The early signs of vascular dementia are subtle and different from typical memory loss.

Early stage

  • Slower thinking

  • Difficulty planning or organizing

  • Poor concentration

  • Mood changes or irritability

  • Mild language or memory problems

Middle stage

  • Personality changes or aggression

  • Depression or emotional instability

  • Trouble finding words

  • Increasing difficulty with daily activities

The decline often happens in steps, worsening suddenly after a stroke or vascular event.


Who Is at Risk?

Vascular dementia is strongly linked to cardiovascular health. Major risk factors include:

  • High blood pressure

  • Diabetes

  • High cholesterol

  • Smoking

  • Obesity

  • Lack of exercise

  • Unhealthy diet

  • Excess alcohol

  • Age over 60

Research shows that uncontrolled blood pressure in midlife is one of the strongest predictors of later cognitive decline.


Can Vascular Dementia Be Treated?

There is no cure, and existing brain damage cannot be reversed. However, progression can often be slowed by protecting the blood vessels.

Doctors may recommend:

  • Blood pressure control

  • Cholesterol-lowering medication

  • Diabetes management

  • Blood-thinning treatment when needed

  • Regular physical activity

  • Weight management

  • A heart-healthy diet

Care planning is also essential to address safety, daily support needs, and long-term social care.


Why Prevention Matters

Vascular dementia is not just a brain condition. It is the long-term result of vascular damage that develops over decades.

Studies suggest that up to 40% of dementia cases may be linked to modifiable risk factors. This means lifestyle changes can delay or reduce risk.

Simple actions that protect the brain:

  • Walking 30 minutes most days

  • Controlling blood pressure and blood sugar

  • Eating a balanced diet

  • Staying socially active

  • Avoiding smoking

In practical terms, what protects the heart also protects the brain.


The Real Message

If symptoms appear at 70, the process often began at 50.

That makes vascular dementia less about aging and more about long-term health decisions.

The good news? Unlike many neurological diseases, this is one condition where prevention still matters.

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