Under the new guidelines, nearly half of all Americans will have high blood pressure. What does this mean for you?
Late last year, the American College of Cardiology and the American Heart Association released new guidelines for what constitutes high blood pressure, or hypertension, effectively putting 46 percent of Americans above the threshold for what is considered safe.
Under the old guidelines, only 1 in 3 American adults were considered to have high blood pressure, which was defined as a reading of 140/90 mmHg. The new guidelines define high blood pressure as 130/80 mmHg.
These new guidelines were developed with nine other health professional organizations to more accurately identify those at risk for serious health issues.
New Guidelines – Low Is Better
Under the new guidelines, blood pressure categories are now defined as:
- Normal: Less than 120/80 mmHg
- Elevated: Systolic between 120 and 129 and diastolic less than 80
- Stage 1 hypertension: Systolic between 130 and 139 or diastolic between 80 and 89
- Stage 2 hypertension: Systolic at least 140 or diastolic at least 90 mmHg
- Hypertensive crisis: Systolic over 180 or diastolic over 120, which requires prompt changes in medication if there are no other indications of problems, or immediate hospitalization if there are signs of organ damage
Since blood pressure fluctuates throughout the day, especially when you’re active or nervous, the guidelines suggest patients have their blood pressures measured in different ways than in the past. For instance, measurements should be taken by an electronic machine after five quiet minutes in the examination room, not on arrival at the practice. Alternatively, some patients may have their blood pressures measured over a period of 24 hours with a specialized home monitor, or keep logs of home measured blood pressure.
Lifestyle Change is Important
A critical step in prevention and treatment is a healthy lifestyle. The new guidelines also highlight the following lifestyle changes for lowering blood pressure:
- Weight loss for those who are overweight and obese
- A healthy diet
- Sodium reduction
- Increased physical activity
- Limited alcohol consumption. For example, it’s recommended that men have no more than two drinks daily. Women should have no more than one drink daily since alcohol.
But even with the new guidelines, treatment must be individualized. What blood pressure target is best for an individual will depend on many factors: their history of diabetes, heart disease, or stroke, coexisting illnesses, and their own personal goals about lifestyle management and medication use. What’s best for a patient in one exam room may not be best for the patient in the next room. It’s important to work together with an experienced heart doctor to make health decisions and to create a plan of action that’s right for you.