What you should know about new high blood pressure guidelines

November 28, 2017 | by Tiana Carrillo, MD
Categories: Healthy Driven Hearts

Do you have high blood pressure? If you didn’t before, you might now, according to new guidelines released by the American Heart Association and 10 other groups. High blood pressure now begins with a reading of 130/80, instead of 140/90.

A Washington Post story says this shift means 46 percent of U.S. adults will be hypertensive — many under age 45. Only 32 percent had high blood pressure based on the previous guidelines. The normal blood-pressure range remains 120/80 or below.

While this might seem alarming, experts see the changes as a good thing. Dr. Monique Tello, in a piece for the Harvard Health Blog, applauds them, "because they are accompanied by solid research, logistical guidance, and useful management strategies."

I believe this update will help medical professionals recognize problems sooner, and prevent premature deaths. That’s pivotal because the consequences of hypertension actually begin at earlier blood-pressure ranges. Hypertension significantly raises the risk of heart disease, stroke and kidney disease.

According to the World Health Organization, stroke and ischemic heart disease, also known as coronary heart disease, are the world’s biggest killers. I tell my patients that hypertension is the top killer, because they usually won’t feel symptoms until it’s too late.

The revised guidelines offer patients an opportunity to make healthier choices. We will have more people diagnosed with hypertension, and a few will need medicine, but lifestyle changes will be the first line of treatment.

For those looking to prevent high blood pressure, some key lifestyle changes include: a healthy diet rich in vegetables, fruits and whole grains, and low in fat; exercising at least five times a week for an hour; reducing caffeine and alcohol consumption; lowering stress levels; and, if you smoke, quitting.

I’m a firm believer that lifestyle changes can provide great results and reduce blood pressure. I’ve had multiple patients who just with lifestyle changes have improved their blood pressure and now are close to not needing medicine. It gives patients a sense of empowerment to know they are impacting their own life. They feel good about themselves and are more motivated to continue.

Also, remember to monitor your blood pressure regularly, and don’t skip doctor visits just because you feel fine. To confirm a hypertension diagnosis, the guidelines recommend self-monitoring away from a doctor’s office. For at least 30 minutes before checking your blood pressure, don’t smoke, drink caffeine or exercise.

As to when someone should start medication, I make the decision for my patients on a case-by-case basis. Typically, if a patient has an accurate blood-pressure reading of 140/90 or above, and if his/her risk for heart disease is 10 percent or more, I prescribe medication.

If you have high blood pressure, managing it means a combination of lifestyle changes and medication. Sometimes genetics play a part, and that’s a factor beyond our control.

Find out your risk for heart and vascular disease with a five-minute HeartAware assessment.

Learn more about heart and vascular services at Edward-Elmhurst Health.

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