I have read summaries of a couple of recent studies (since 2000)
indicating that "normal" and "high normal" {*filter*} pressure per AHA
guidelines can result in target organ damage.

How rigorous and well-accepted are these studies?  

Do the AHA guidelines need revision, and is this likely in the near
future?

I have until recently been in the "high normal" range even with
treatment from a board-cert. cardiologist for decades.  I was only
taking 5 mg Altace.  He seemed satisfied with this since various tests
including cardiac ultrasound remained normal.  At present I am in the
"optimal" range since increasing Altace to 10 mg following recent BP
increases into the hypertensive range.

Given these recent studies, I'm now troubled that my treatment was not
more aggressive all along, but I trusted his expertise and judgement.
He seemed more concerned about my diet, exercise, healthy lifestyle,
and absence of medication side effects, over BP reduction into the
optimal range.

I only recall one physician during a brief exam about 20 years ago
telling me that high normal was not good, and that I shouldn't be
satisfied with high normal.  All others I saw for various unrelated
reasons seemed unconcerned.

Is the community at large lagging the best science?  Thanks.

Guidelines were revised this year, see
http://www.***.com/

I don't think it's fair to blame your docs for following the
guidelines at the time. Instead of blaming doctors how about taking
personal responibility by eating a healthy diet and exercising?
According to Dr. Willett from Harvard, 80% of CHD in America is due to
poor diet and exercise habits.  See
http://www.***.com/

See the recent thread "Flowmax" on this NG. This was my experience after six
days of Flowmax.

After starting Flowmax and Proscar last Tuesday my BP was lower than usual
the next morning and eventually went as low as 106/58 but my normally drug
induced pulse rate of under 50 was up to 61. By evening the headache began
and by Sunday my BP was much higher than normal all day. I woke up early
Monday morning with my heart pounding and checked my BP and pulse getting a
reading of 214/85 and a pulse of 112. Alarmed my wife phoned the docter who
came round to check me out. He said that my BP was still as high but heart
sounded all right and that my pulse had gone to 90. He had never heard of
such a reaction before but to stop taking the medication.

I did a Google search and found others who had a similar problem with Alpha
Blockers:-

"I have had bph  problems for quite a while now. I have tried Cordura
and it really made me dizzy. I have tried Hytrin  which I may have to
go back too. I was only taking 2 mgs a day, but it was helping a little.
The problem was it was making my heart beat pretty rapidlyt at times
and I decided to discontinue it".

Also:-
"A few days ago, I read an article in "Worst Pills, Best Pills" newsletter

warning of the dangers of alpha-blocker {*filter*}. The article, by Sidney Wolfe,

M.D., cautioned that these {*filter*} can significantly increase the chance of

heart attack or stroke. The article specifically named Cardura, Hytrin and

Flomax, all of which belong to the alpha-blocker family. Although, I had

been taking Flomax for the last two years and Proscar for more than five

years, I reluctantly decided to discontinue the Flomax out of concern that I

might increase my risk of stroke"

Also:-----

" I was having dizzy spells, weakness and after very little exertion, my
pulse rate would go sky

high. I normally have low {*filter*} pressure and that might have been some of

the problem. The fact that there are increased cases of congestive heart

failure and stroke are enough to make you think twice or more about taking

it".

When I posted  my problem on a cardiac NG I got this reply from a Doctor:-

" I would wonder about the Flomax interacting with the verapamil by

 lowering levels of the latter. This would raise both your heart rate

 and your BP"

Derek.

Thanks - very helpful.

Thanks - I see your point . . .