Scam may be the wrong word. "Mis-guided", "wrong-headed", "inappropriate" hit the mark for me.
1-Is chronic hypertension a "Risk factor" for dying?= Yes, of course
One can't really argue that chronically-elevated blood pressure is at least "associated" with (has a direct correlation with and therefore is a so-called "risk factor") cardiovascular-related death. At least this is true in the generally-sick, grain-fed, sedentary, stressed-out populations that have been studied. (i.e Western societies)
(side bar: Those Paleohackers just beginning in their quest for better health and more knowledge must make sure you clearly understand the difference btwn "risk factor" and "cause", very important.)
2-Does drug intervention cause decreased deaths?= not proven.
The current (sickness paradigm- driven) medical approach of trying to save lives (prevent heart attacks and strokes, etc.) via chemically-altering/lowering chronically-elevated BP (wherein the elevated BP is simply a 'correct', genetically-programmed response to multiple chronic physiological stressors i.e. wrong diet, insufficient physical activity, and chronic mental/emotional stress, et al) is not science-based when looked at holistically.
The epidemiological studies which purport to show drug interventions as beneficial, do indeed show a tiny total mortality benefit from lowering BP via meds. In other words, there appears, on face, to be a very, very small absolute benefit with the use of various drugs.
(Side bar #2: Note to all newer PaleoHackers: make sure you understand the difference between an absolute vs a relative benefit and/or risk....VERY important!)
But, these studies have failed to actually tease out/separate the artificial lowering of the BP (via meds) from other important (actually-beneficial) factors including the positive lifestyle changes that inevitably follow a medical diagnosis and prescription. Therefore, in truth, it is not possible to say for sure that these meds directly CAUSE a tiny decrease in cardio-related deaths OR whether they are simply ASSOCIATED with a tiny decrease in mortality (via the complex array of events that occur in the life of a human being who gets diagnosed with hypertension [a life-threating Dx in their minds no doubt] and then is placed on meds and is now staring at their own mortality and probably making some changes in their lifestyle that are indeed beneficial to overall physiological function.
A growing number of mainstream medical practitioners are beginning to recognize these facts and as they more become educated in a true wellness paradigm (I look at this Paleo movement as being under the umbrella of a greater wellness paradigm), they will start to change their approach. A precious few are speaking out now, but it will continue to take time.