New Blood Pressure Rules

Brian Bostick, MD, PhD, is a MU Health Care cardiologist. In this Q&A session, he explains the new standards and how to keep your blood pressure in the normal range below 120/80. Wright, who was also a member of the 2003 expert panel, supports meeting these recommendations for treating blood pressure above 140/90. The new guidelines – the first comprehensive since 2003 – lower the definition of high blood pressure to account for complications that can occur with lower numbers and to allow for earlier intervention. The new definition will result in nearly half of the U.S. adult population (46%) suffering from high blood pressure, with the greatest impact expected in young people. In addition, the prevalence of hypertension is expected to triple in men under 45 and double in women under 45, the guideline authors note. However, only a small increase in the number of adults requiring antihypertensive drugs is expected. The controversy began when a group of 17 national experts announced in December that, based on a five-year analysis of the best available research, the goal of treating high blood pressure should be slightly raised for people aged 60 and older and for people with diabetes or kidney disease.

His findings were published in the Journal of the American Medical Association. High blood pressure needs to be treated earlier with lifestyle changes and in some patients with medication – at 130/80 mm Hg instead of 140/90 – based on new guidelines from ACC and the American Heart Association (AHA) for the detection, prevention, treatment and management of high blood pressure. • After starting treatment, the target blood pressure is below 140/90 mm Hg within three months and after three months in patients under 65 years of age to less than 130/80 mm Hg. A: This new classification does not mean that you or your doctor have done anything wrong with your blood pressure. We have always rated blood pressure above 120/80 as elevated. The goal of the new classification is to raise awareness of high blood pressure and improve treatment. By diagnosing high blood pressure earlier, we can help prevent more heart attacks and strokes. These new guidelines will not necessarily change if you are prescribed medication for your high blood pressure or what medications you are taking – values. We always prescribe the same medications you used to take. We try to give everyone access to the treatments they need and to aggressive treatment earlier. We focus much more on diet, weight loss, and exercise. New blood pressure guidelines could be dangerous for some.

This seemed like good news for thousands of older people: new blood pressure guidelines could free them from the fear of taking powerful drugs to control their blood pressure and the side effects these pills sometimes bring. Subscribe to the AARP Health newsletter “High blood pressure is a very important risk factor, especially if you have other diseases. Now is not the time to relax blood pressure control,” said group president Mariell Jessup, MD, medical director of the University of Pennsylvania Heart and Vascular Center. If you`re an American adult, there`s a 46% chance you have high blood pressure. The odds increased in November when the American Heart Association and the American College of Cardiology released new standards that lowered the threshold for diagnosing high blood pressure. The new guidelines don`t change anything if you`re under 60. But if you`re 60 or older, the goal has increased: your goal is to keep your blood pressure at 150/90 or less. If you have kidney disease or diabetes, your goal was 130/80 or less; Now it is 140/90 or less. The new definition of stage 1 hypertension is a systolic pressure of at least 130 or a diastolic pressure of 80 or higher. Systolic refers to pressure during heart contractions and diastolic refers to pressure between strokes. The previous standard was 140/90.

A: Yes. That`s why we don`t want to consume caffeine 30 minutes before your appointment. We don`t want you to exercise 30 minutes before the blood pressure check. And we don`t want you to smoke 30 minutes before blood pressure is checked. We want you to be able to sit for five minutes and lie with your feet on the floor so you can relax. When blood pressure is checked, you want to make sure the cuff is above elbow level. Make sure you don`t speak during the exam. The guidelines also emphasize that you check your blood pressure again within 30 minutes if it`s high, and then average those numbers.

The guidelines also redefined the different categories of hypertension. It eliminated the prehypertension category, which had been defined as systolic blood pressure of 120 to 139 mm Hg or diastolic pressure (the lowest number in a measurement) of 80 to 89 mm Hg. Instead, people with these readings are now classified as high blood pressure (120 to 129 systolic and less than 80 diastolic) or stage 1 hypertension (130 to 139 systolic or 80 to 89 diastolic). The change meant that an additional 30 million American adults had high blood pressure. “A blood pressure of 150/90 in a patient who is fundamentally healthy but may need to make dietary or lifestyle changes is not the same as another 150/90 who is a ticking time bomb because they have other risk factors,” she points out. But every patient is different, he says. And while “some are better off with a blood pressure of 130, others with blood pressure of 140 to 146 and who are already taking 11 medications, do not need to add a 12th pill to lower their blood pressure to 138. A physician`s judgment trumps guidelines. A: It can make a big difference. Every kilogram you lose — about 2 to 2 1/2 pounds — has been shown in studies to lower your systolic blood pressure by one point. We recommend the DASH diet, which is low in salt, low in cholesterol, low in fat and high in vegetables.

This can lower your blood pressure by five to 10 points. Certainly, things like quitting smoking can have a big impact on your blood pressure and risk. If you`ve never had high blood pressure before, chances are you do now. Since blood pressure values vary depending on the measurement technique, the diagnostic criteria are specific to the technique (Table 1). In healthcare settings, which include the doctor`s office, hypertension is diagnosed when blood pressure is 140/90 mm Hg or higher, ideally using an electronic device and following standard measurement protocols, including repeated measurements. A: High blood pressure is one of the biggest risk factors for heart disease and stroke. Lower blood pressure is associated with better outcomes. This group looked at all the studies and determined the link between each blood pressure level and your risk of heart disease and stroke. Redefining these, while classifying more people with stage 1 hypertension, will give them better access to high blood pressure treatments, therapies, knowledge and awareness so we can prevent heart disease and stroke. New blood pressure guidelines could exempt some from taking potent medications with strong side effects.

According to Jackson T. Wright Jr., MD, author of the minority view and director of the hypertension clinical program at University Hospitals Case Medical Center in Cleveland, this could put older adults with untreated high blood pressure at higher risk of complications — especially for African Americans and those with additional cardiovascular risk factors. The blood pressure categories in the new guideline are as follows: The previous group`s guidelines in 2003 defined high blood pressure in seniors as 140/90 or higher, meaning that this is the threshold for taking medication to lower these numbers. (The top number represents the pressure in the arteries when the heart beats, and the lower number is the pressure between beats when the heart rests.) In the first three months after starting drug therapy, the target BP should be less than 140/90 mm Hg. Long-term recommended blood pressure targets are less than 130/80 mm Hg in patients younger than 65 years of age and less than 140/90 mm Hg in patients 65 years of age or older. “You`ve already doubled your risk of cardiovascular complications compared to those with normal blood pressure,” Paul K. said. Whelton, MB, MD, MSc, FACC, lead author of the guidelines. “We want to be direct with people – if you already have doubled risk, you need to know that. This doesn`t mean you need medication, but it`s a yellow light you need to lower your blood pressure, mainly using non-drug approaches.

“The biggest problem is that many men aged 65 and older are suddenly diagnosed with high blood pressure or high blood pressure because the new normal is 20 points lower than before.