Heart Association lowers definition of high blood pressure

Lydia Fleming
November 15, 2017

With the new guidelines, that patient will be "read the riot act" about exercise and healthy eating but the goal will be for them to bring their blood pressure down with those lifestyle changes before prescribing medications, Gandhi said.

Doctors now recognize that complications "can occur at those lower numbers", said the first update to comprehensive USA guidelines on blood pressure detection and treatment since 2003.

However, the AHA advises "stage one" patients with blood pressure between 130/80 and 140/90 to lose weight, exercise and eat lots of fruits, vegetables and whole grains before trying medication. Normal blood pressure is less than 120/80 mm Hg; elevated is systolic between 120-129 and diastolic less than 80; Stage I is systolic between 130-139 or diastolic between 80-89; and Stage II is systolic at least 140 or diastolic at least 90 mm Hg.

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Tighter blood pressure guidelines from US heart organizations mean millions more people need to make lifestyle changes, or start taking medication, in order to avoid cardiovascular problems. "We want to be straight with people - if you already have a doubling of risk, you need to know about it".

"The prevalence of hypertension among USA adults is substantially higher when the definition in the present guideline is used versus the [older] definition (46% versus 32%)", the authors write.

Today, millions of Americans who didn't have high blood pressure before have it now.

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Doctors often call high blood pressure the "silent killer" because it's second-leading cause of preventable death in the United States, behind cigarette smoking.

The new guidelines eliminate the prehypertension category.

"It's very clear that their future risk of heart attack and stroke down the road is almost doubled compared to patients with lower numbers", Farrell said. Dr. Fabregas says when the high pressure ruins those pipes, or blood vessels, the heart has to work harder to pump blood.

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Dr Satjit Bhusri, a cardiologist at Lenox Hill Hospital in NY, said he agrees with the change "because it allows for early lifestyle changes to be addressed".

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