High Blood Pressure Redefined For First Time In 14 Years: 130 Is the New High

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Most African-American Men and Women Will Have High Blood Pressure Under New American Heart Association/American College of Cardiology Guidelines

HIGHLIGHTS:
  • High blood pressure is now defined as readings of 130 mm Hg and higher for the systolic blood pressure  meaurement, or readings of 80 and higher for the diastolic measurement. That is a change from the old definition of 140/90 and higher, reflecting complications that can occur at those lower numbers.
  • Among African-Americans, 56 percent of women and 59 percent of men will have high blood pressure under the new guidelines. The change means African-American men have the highest rate of hypertension; previously, black women did.
  • In the first update to comprehensive U.S. guidelines on blood pressure detection and treatment since 2003, the category of prehypertension is eliminated.
  • While about 14 percent more people will be diagnosed with high blood pressure and counseled about lifestyle changes, there will only be a small increase in those who will be prescribed medication.
  • By lowering the definition of high blood pressure, the guidelines recommend earlier intervention to prevent further increases in blood pressure and the complications of hypertension.
High blood pressure accounts for the second largest number of preventable heart disease and stroke deaths, following smoking. It’s known as the “silent killer” because many times there are no obvious symptoms, and it significantly increases the risk for heart disease and stroke.

High blood pressure should be treated earlier with lifestyle changes and in some patients with medication – at 130/80 mm Hg rather than 140/90 – according to the first comprehensive new high blood pressure guidelines in more than a decade. The guidelines are being published by theAmerican Heart Association (AHA) and the American College of Cardiology (ACC) for detection, prevention, management and treatment of high blood pressure.  The guidelines were presented last month at the Association’s 2017 Scientific Sessions conference in Anaheim, Calif., the premier global cardiovascular science meeting for the exchange of the latest advances in cardiovascular science for researchers and clinicians.

Rather than 1 in 3 U.S. adults having high blood pressure (32 percent) with the previous definition, the new guidelines will result in nearly half of the U.S. adult population (46 percent) having high blood pressure, or hypertension.  However, there will only be a small increase in the number of U.S. adults who will require antihypertensive medication, authors said. Additionally, more African-Americans, a population that faces a higher risk for high blood pressure than other demographics, will have high blood pressure under the new guidelines. Fifty-six percent of women will be affected compared to 59 percent of men, which reflects an increase from 42 percent for women and 46 percent for men. This now means African-American men have the highest rate of hypertension while, previously, black women did.

These guidelines, the first update to offer comprehensive guidance to doctors on managing adults with high blood pressure since 2003, are designed to help people address the potentially deadly condition much earlier.  The new guidelines stress the importance of using proper technique to measure blood pressure. Blood pressure levels should be based on an average of two to three readings on at least two different occasions, the authors said.

Paul K. Whelton, M.B., M.D., M.Sc., lead author of the guidelines published in the American Heart Association journal, Hypertension, and the Journal of the American College of Cardiology, noted the dangers of blood pressure levels between 130-139/80-89 mm Hg.

“You’ve already doubled your risk of cardiovascular complications compared to those with a normal level of blood pressure,” he said. “We want to be straight with people – if you already have a doubling of risk, you need to know about it. 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.”

The new guidelines eliminate the category of prehypertension, which was used for blood pressures with a top number (systolic) between 120-139 mm Hg or a bottom number (diastolic) between 80-89 mm Hg. People with those readings now will be categorized as having either Elevated (120-129 and less than 80) or Stage I hypertension (130-139 or 80-89).  Previous guidelines classified 140/90 mm Hg as Stage 1 hypertension. This level is classified as Stage 2 hypertension under the new guidelines.

The impact of the new guidelines is expected to be greatest among younger people. The prevalence of high blood pressure is expected to triple among men under age 45, and double among women under 45 according to the report. For African-Americans, high blood pressure develops earlier in life and is usually more severe.

The new guidelines were developed by the American Heart Association, American College of Cardiology and nine other health professional organizations. They were written by a panel of 21 scientists and health experts who reviewed more than 900 published studies.

To read more about the new guidelines, log on to heart.org.
SOURCE: The Bellamy Group

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