Recently released guidelines have lowered the definition for high blood pressure, which increases the number of people identified as having hypertension and being at risk for serious medical problems because of it.
High blood pressure used to be defined as 140/90. New guidelines released by the American Heart Association have lowered the definition of hypertension to 130/80. Less than 120 is now considered normal. And 120 to 129 is now “elevated.”
The change means 46 percent of U.S. adults are identified as having high blood pressure, compared with 32 percent under the previous definition.
Dr. Carl Horton, a cardiologist with Texas Health Physicians Group, thinks the changes are intended to get physicians to find and begin treating patients earlier.
Purpose of the new guidelines: There is some data suggesting that the higher your blood pressure, the higher the likelihood that you’ll develop cardiovascular disease. People that have high blood pressure have a greater-than-twofold risk of developing cardiovascular disease in the future. So the emphasis, I think, is to get physicians to start treating more aggressively and earlier.
Will more people have to take medication? Definitely. For patients who have blood pressure that is 130/80, if they have underlying cardiovascular disease, if they’re diabetic, if they have kidney disease, if they’ve had a stroke or TIA, it’s definitely recommended that they start pharmacologic therapy to lower their blood pressure. For patients who don’t have those conditions, but who do have a risk of developing cardiovascular disease that’s considered 10 percent by the Framingham Risk Score, then it's recommended also that doctors treat those patients.
For those who don’t require medication, the recommendation would be lifestyle changes:
- Weight loss
- Restrict sodium use
- Increase intake of potassium
- Repeat blood pressure reading in three to six months.
Guideline controversies regarding older people: Traditionally, the targets weren’t as aggressive for older people. It used to be 150/90. With these new clinical trials that have come out, it suggests even older populations benefit from having their blood pressure lower than 150/90 and closer to 130/80.
How to take blood pressure manually
- American College of Cardiology: New hypertension guidelines
- American Heart Association: New Guidelines
Interview responses have been lightly edited for clarity and length.