“High” Blood Pressure Guidelines

The guidelines for what is considered “high blood pressure” have been revised, a development that will categorize many more adults in the US as hypertensive. Leading heart health experts made this change in order to motivate adults and doctors to better treat and prevent this serious health condition.

The American Heart Association, the American College of Cardiology, and nine other groups have redefined what is considered high blood pressure: 130 over 80 instead of the former 140 over 90. The former figure has been standard for 14 years. (Normal blood pressure remains less than 120 over 80.)

Robert M. Carey, co-chairman of the group that authored the new report, stated, “We're recognizing that blood pressures that we in the past thought were normal or so-called pre-hypertensive actually placed the patient at significant risk for heart disease and death and disability.” The new standard aims to better recognize the risk associated with hypertension. Under the former guidelines, 32% of US adults were considered to have high blood pressure. Under the revised categories, 46% of adults, a number of them younger than 45, are defined as hypertensive. The report’s authors believe that the new guideline will triple the number of young men and double the number of young women who are considered hypertensive.

Although many more adults are considered hypertensive under these guidelines, medical experts hope this won’t necessarily mean a rise in medication use. Instead, losing weight, improving diet, getting more exercise, drinking less alcohol, and reducing stress are suggested to address the risk of high blood pressure levels. The former president of the American College of Cardiology, Richard Chazal, stated, “An important cornerstone of these new guidelines is a strong emphasis on lifestyle changes as the first line of therapy.” Although some physicians with outdated science recommend reducing dietary salt to reduce blood pressure, low salt intake is more likely to raise blood pressure than to reduce it. Reducing dietary salt is proven to increase risk of heart attacks, heart disease, and strokes.

Most health care providers will follow the report’s new blood pressure guidelines, along with developments in the report that create new categories such as “elevated,” “Stage 1,” Stage 2,” and “hypertensive crisis” defined by different blood pressure levels. These categories, like the new “high” for blood pressure, aim to recognize and proactively treat the risks associated with high blood pressure. Hypertension is the leading cause of death across the globe, and is the US’s second-highest cause of preventable death after tobacco smoking. Risks associated with hypertension include strokes, severe kidney disease, and cardiovascular disease. Unfortunately, many people are not aware that they have high blood pressure because there are no symptoms.

Physicians tend to under-diagnose hypertension if it’s the only health issue a patient has. For otherwise healthy patients, physicians are less likely to prescribe medication for hypertension. This is one factor that makes hypertension “the silent killer.”

Maintaining blood pressure below 120/80 will reduce the risks of heart attack and stroke. Keep an eye on your blood pressure level and actively adopt healthy exercise and eating habits to avoid the world’s leading cause of death.