New guidelines will mean millions more diagnosed with high blood pressure

Henrietta Strickland
November 14, 2017

The normal limit for blood pressure is considered 120/80.

Most of those added people will be urged to change their diets, exercise more and make other lifestyle changes, rather than take medication. The number of Americans with hypertension who are recommended for medical treatment would increase by only 4.2 million adults, or 5 percent more than were previously recommended.

The changes are expected to drastically impact adult Americans: revising the hypertension threshold downward will increase the percent of US adults living with high blood pressure from 32 percent to 46 percent - almost half of the adult population.

The guidelines, presented at a heart association meeting and published in Hypertension and the Journal of the American College of Cardiology, also spell out exactly how health care providers and people at home should check blood pressure.

Data from SPRINT, which was also used in the new meta-analyses that were done for the guidelines, supports the lower blood pressure goal of 130/80 mm Hg for adults, including adults aged 65 years and older in institutionalized ambulatory, community-living settings, according to MacLaughlin.

Kenneth Jamerson, M.D., Ph.D., professor of internal medicine and hypertension specialist at the University of MI was one of almost two dozen medical experts who wrote the new guidelines.

In addition to tightening the definition of high blood pressure, the new report does away with the old category of "pre-hypertension", which was defined as a top (systolic) reading of 120 to 139 or a bottom (diastolic) number between 80 and 89. The bottom number refers to your blood pressure when your heart muscle is between beats.

In 2010, high blood pressure was the leading cause of death worldwide and the second-leading cause of preventable death in the United States, after cigarette smoking. And an increasing risk of heart attack and stroke. Damage to the inside of arteries and other blood vessels can grow over time, and rates of hypertension increase with age.

Potentially deadly high blood pressure can be brought under control with a wide array of medications, many sold as relatively cheap generics. The prevalence of high blood pressure is expected to triple among men under age 45 and double among women under 45.

In developing the guidelines, authors also analyzed more than 900 research studies, excluding those that did not meet strict research requirements.

Thomas Frieden, the former director of the U.S. Centers for Disease Control and Prevention who now runs a global health initiative that focuses on heart disease and stroke, said that the "big news about this guideline is it should end forever any debate about whether people should be treated with medicines once they hit 140/90". "It doesn't mean you need medication, but it's a yellow light that you need to be lowering your blood pressure, mainly with non-drug approaches". There are no obvious symptoms, which is why it is often called, "the silent killer".

"People with white-coat hypertension do not seem to have the same elevation in risk as someone with true sustained high blood pressure", Whelton said.

Other reports by Click Lancashire

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