High blood pressure redefined under new guidelines

High blood pressure redefined under new guidelines

HATTIESBURG, MS (WDAM) - For the first time in 14 years, the American Heart Association and the American College of Cardiology have redefined high blood pressure from the old definition of 140/90 mm Hg to 130/80 mm Hg.

The statement was released November 13 stating that guidelines were put in place "for detection, prevention, management and treatment of high blood pressure."

Studies show that nearly half of the adult U.S. population (46 percent) will have high blood pressure, or hypertension, under the new guidelines in comparison to only 1 in 3 U.S adults having high blood pressure under the old definition.

"High blood pressure accounts for the second largest number of preventable heart disease and stroke deaths, second only to smoking," the statement said. "It's known as the 'silent killer' because often there are no symptoms, despite its role in significantly increasing the risk for heart disease and stroke."

The new guideline also eliminates the prehypertension category.  This means that under the new guidelines people who have a blood pressure reading of systolic between 130 - 139 mm Hg will now be considered in stage 1 hypertension. People who have a blood pressure reading of systolic between 120 – 139 mm Hg will be categorized as Elevated.

Stage 2 hypertension is classified as being systolic at least 140 mm Hg.

The new guidelines are as follows according to the statement:

  • Normal: Less than 120/80 mm Hg;
  • Elevated: Top number (systolic) between 120-129 and bottom number (diastolic) less than 80;
  • Stage 1: Systolic between 130-139 or diastolic between 80-89;
  • Stage 2: Systolic at least 140 or diastolic at least 90 mm Hg;
  • Hypertensive crisis: Top number over 180 and/or bottom number over 120, with patients needing prompt changes in medication if there are no other indications of problems, or immediate hospitalization if there are signs of organ damage.

According to the statement,

"The guidelines stress the importance of home blood pressure monitoring using validated devices and appropriate training of healthcare providers to reveal "white-coat hypertension," which occurs when pressure is elevated in a medical setting but not in everyday life. Home readings can also identify "masked hypertension," when pressure is normal in a medical setting but elevated at home, thus necessitating treatment with lifestyle and possibly medications."

The statement also states that despite more Americans being prone to high blood pressure, studies show that only a small percentage will need to be medicated.

Other changes from the statement are listed below:

  • Only prescribing medication for Stage I hypertension if a patient has already had a cardiovascular event such as a heart attack or stroke, or is at high risk of heart attack or stroke based on age, the presence of diabetes mellitus, chronic kidney disease or calculation of atherosclerotic risk (using the same risk calculator used in evaluating high cholesterol).
  • Recognizing that many people will need two or more types of medications to control their blood pressure, and that people may take their pills more consistently if multiple medications are combined into a single pill.
  • Identifying socioeconomic status and psychosocial stress as risk factors for high blood pressure that should be considered in a patient’s plan of care.

You can view the full statement here.