Big News About High Blood Pressure

New Guidelines Change How Hypertension Is Determined and Treated

If you or someone you love has high blood pressure or is prehypertensive, new blood pressure guidelines may affect you. Recently the American Heart Association and the American College of Cardiology revised the guidelines for high blood pressure. Specifically, high blood pressure should be treated earlier with lifestyle changes — and in some patients with medication — at 130/80 mm Hg, rather than 140/90 mm Hg.

As a result, where you fall on the spectrum of blood pressure categories may have changed. The categories are outlined in the new guidelines as:

• Normal — Less than 120/80 mm Hg
• Elevated — Systolic between 120–129 and diastolic less than 80
• Stage 1 Hypertension — Systolic between 130–139 or diastolic between 80–89
• Stage 2 Hypertension — Systolic at least 140 or diastolic at least 90 mm Hg
• Hypertensive crisis — Systolic over 180 and/or diastolic 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.

Prehypertension is no longer a category; instead, people would fall into the elevated or Stage I hypertension categories.

In addition, the guidelines stress the importance of using proper technique to measure blood pressure and recommend the use of home blood pressure monitoring.

Other changes that the new guidelines suggest are:

• Prescribing medication for Stage I hypertension only 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 or chronic kidney disease; or if the patient is at high risk for atherosclerosis.
• Considering socioeconomic status and psychosocial stress as risk factors for high blood pressure that should be considered in a patient’s plan of care.

Speak to your doctor if you have any questions or wonder how these guidelines affect you.