Redefining High Blood Pressure - How New Guidelines May Affect You

Nearly half of Americans (46 percent) have high blood pressure, according to new guidelines recently approved by the American College of Cardiology, American Heart Association and several influential medical organizations.

The 2017 guidelines say if your blood pressure is 130/80 or above, you have hypertension, the medical term for high blood pressure. From 120 to 129/80 is considered elevated, and less than 120/80 is normal. Previously, doctors defined high blood pressure as 140/90.

TriHealth Heart Institute System Chief Stephen Lewis, MD and Cardiologist Pete Caples, MD weighed in on the potential impact of the new guidelines.

Both doctors agree that the stricter standards should get the attention of doctors and their patients with hypertension.

“We can’t refute the danger of high blood pressure,” Dr. Caples states. “We’ve struggled to get people to 140/90. This will absolutely change my practice. It could mean a lot more medication for a lot more people.”

Dr. Lewis is hopeful the new guidelines will help create greater awareness. “Ignoring or leaving hypertension untreated is a losing proposition,” he says.

The doctors concur that an individual’s total risk factors for heart disease and stroke are important to the overall treatment plan. In addition to hypertension, these include conditions like diabetes mellitus, hyperlipidemia (high cholesterol), smoking, poor diet and sedentary lifestyle.

They share a concern for not driving blood pressure too low, which could lead to kidney or brain damage, especially in older people.

Why Blood Pressure Matters

Many people with hypertension can live for years without feeling the negative effects of high blood pressure. The damage is cumulative, however, putting people with high numbers at greater risk for kidney failure, heart failure, heart attack, peripheral arterial disease and stroke.

Your blood pressure measurement includes the systolic pressure (upper number), indicating the pressure exerted against your artery walls when your heart beats. Diastolic pressure (the lower number) measures the pressure on your artery walls while your heart is at rest.

“High blood pressure creates wear and tear on your arteries and heart,” says Dr. Lewis. “Treat your body like you would a fine automobile and it won’t break down prematurely.” 

Both doctors acknowledge the benefits of diagnosing and treating the problem early.

Dr. Caples says, “Hypertension is not a middle-aged disease. Start measuring your blood pressure in your 20s and then check it periodically.”

Dr. Lewis points out that untreated hypertension in a young person can have devastating consequences later in life, including premature heart attack, stroke or death.

“Lifestyle changes are the cornerstone for treating the hypertensive individual. Step one is to empower the patient to actively participate in their own care,” Dr. Lewis says.

This means learning and adopting the Mediterranean diet or DASH diet, which focus on fresh fruits and vegetables, beans and nuts, healthy fat like olive oil, and lean meat like fish and chicken.  Emphasize exercise, weight control and limit alcohol.  Seek treatment for sleep disorders, which may also dramatically improve blood pressure control.

“When you follow through with healthy lifestyle choices, blood pressure often comes down without additional medications,” he says.

Dr. Caples concludes, “We want to convince people that it’s important to pay attention to high blood pressure. These new guidelines might help with that.”

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