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Is your blood pressure within normal limits? Check out these new guidelines to be sure
The National Heart, Lung, and Blood Institute (NHLBI) released new guidelines for the prevention, detection, and treatment of high blood pressure. The guidelines, feature altered blood pressure categories, including a new "prehypertension" level-which covers about 22 percent of American adults or about 45 million persons.
The new guidelines also streamline the steps by which doctors diagnose and treat patients, and recommend the use of diuretics as part of the drug treatment plan for high blood pressure in most patients.
The guidelines were prepared by a special committee of the NHBPEP, which represents 46 professional, voluntary, and federal organizations, and reviewed by 33 national hypertension experts and policy leaders. The NHBPEP issues new guidelines when warranted by scientific advances. The last guidelines were issued in November, 1997.
"Since 1997, much more has been learned about the risk of high blood pressure and the course of the disease," said NHLBI Director Dr. Claude Lenfant. "Americans' lifetime risk of developing hypertension is much greater than we'd thought. For instance, those who do not have hypertension at age 55 have a 90 percent risk of going on to develop the condition.
"We also now know that damage to arteries begins at fairly low blood pressure levels-those formerly considered normal and optimal," he continued. "In fact, studies show that the risk of death from heart disease and stroke begins to rise at blood pressures as low as 115 over 75, and that it doubles for each 20 over 10 millimeters of mercury (mm Hg) increase. So the harm starts long before people get treatment.
"Unless prevention steps are taken, stiffness and other damage to arteries worsen with age and make high blood pressure more and more difficult to treat. The new prehypertension category reflects this risk and, we hope, will prompt people to take preventive action early."
High blood pressure is a major risk factor for heart disease and the chief risk factor for stroke and heart failure and also can lead to kidney damage. It affects about 50 million Americans-one in four adults. Treatment seeks to lower blood pressure to less than 140 mm Hg systolic and less than 90 mm Hg diastolic for most persons with hypertension (less than 130 systolic and less than 80 diastolic for those with diabetes and chronic kidney disease).
The guidelines stress that most patients will need more than one drug to control their hypertension and that lifestyle measures are a crucial part of treatment.
"Another key factor is the need for clinicians to pay more attention to systolic blood pressure in those age 50 and older," he continued. "From mid-life on, systolic hypertension is a more important cardiovascular risk factor than diastolic. It's also much more common and harder to control."
Key aspects of the new guidelines include a new "prehypertension" level and merging of other categories. The new prehypertension category should alert people to their real risk from high blood pressure. The new report changes the former blood pressure definitions to:
Normal: less than 120/less than 80 mm Hg;
Pre-hypertension: 120-139/80-89 mm Hg
Stage 1 hypertension: 140-159/90-99 mm Hg
Stage 2 hypertension: at or greater than 160/at or greater than 100 mm Hg
The guidelines do not recommend drug therapy for those with prehypertension unless it is required by another condition, such as diabetes or chronic kidney disease. But the report advises them-and encourages those with normal blood pressures-to make any needed lifestyle changes.
These include:
losing excess weight
becoming physically active
limiting alcoholic beverages
quitting smoking (for overall cardiovascular health)
following a heart-healthy eating plan, including cutting back on salt and other forms of sodium.
SPECIFICALLY, follow the DASH-Dietary Approaches to Stop Hypertension-eating plan, which is rich in vegetables, fruit, and nonfat dairy products. DASH significantly lowers blood pressure. The decreases are often comparable to those achieved with blood pressure-lowering medication.
The National Heart, Lung, and Blood Institute (NHLBI) released new guidelines for the prevention, detection, and treatment of high blood pressure. The guidelines, feature altered blood pressure categories, including a new "prehypertension" level-which covers about 22 percent of American adults or about 45 million persons.
The new guidelines also streamline the steps by which doctors diagnose and treat patients, and recommend the use of diuretics as part of the drug treatment plan for high blood pressure in most patients.
The guidelines were prepared by a special committee of the NHBPEP, which represents 46 professional, voluntary, and federal organizations, and reviewed by 33 national hypertension experts and policy leaders. The NHBPEP issues new guidelines when warranted by scientific advances. The last guidelines were issued in November, 1997.
"Since 1997, much more has been learned about the risk of high blood pressure and the course of the disease," said NHLBI Director Dr. Claude Lenfant. "Americans' lifetime risk of developing hypertension is much greater than we'd thought. For instance, those who do not have hypertension at age 55 have a 90 percent risk of going on to develop the condition.
"We also now know that damage to arteries begins at fairly low blood pressure levels-those formerly considered normal and optimal," he continued. "In fact, studies show that the risk of death from heart disease and stroke begins to rise at blood pressures as low as 115 over 75, and that it doubles for each 20 over 10 millimeters of mercury (mm Hg) increase. So the harm starts long before people get treatment.
"Unless prevention steps are taken, stiffness and other damage to arteries worsen with age and make high blood pressure more and more difficult to treat. The new prehypertension category reflects this risk and, we hope, will prompt people to take preventive action early."
High blood pressure is a major risk factor for heart disease and the chief risk factor for stroke and heart failure and also can lead to kidney damage. It affects about 50 million Americans-one in four adults. Treatment seeks to lower blood pressure to less than 140 mm Hg systolic and less than 90 mm Hg diastolic for most persons with hypertension (less than 130 systolic and less than 80 diastolic for those with diabetes and chronic kidney disease).
The guidelines stress that most patients will need more than one drug to control their hypertension and that lifestyle measures are a crucial part of treatment.
"Another key factor is the need for clinicians to pay more attention to systolic blood pressure in those age 50 and older," he continued. "From mid-life on, systolic hypertension is a more important cardiovascular risk factor than diastolic. It's also much more common and harder to control."
Key aspects of the new guidelines include a new "prehypertension" level and merging of other categories. The new prehypertension category should alert people to their real risk from high blood pressure. The new report changes the former blood pressure definitions to:
Normal: less than 120/less than 80 mm Hg;
Pre-hypertension: 120-139/80-89 mm Hg
Stage 1 hypertension: 140-159/90-99 mm Hg
Stage 2 hypertension: at or greater than 160/at or greater than 100 mm Hg
The guidelines do not recommend drug therapy for those with prehypertension unless it is required by another condition, such as diabetes or chronic kidney disease. But the report advises them-and encourages those with normal blood pressures-to make any needed lifestyle changes.
These include:
losing excess weight
becoming physically active
limiting alcoholic beverages
quitting smoking (for overall cardiovascular health)
following a heart-healthy eating plan, including cutting back on salt and other forms of sodium.
SPECIFICALLY, follow the DASH-Dietary Approaches to Stop Hypertension-eating plan, which is rich in vegetables, fruit, and nonfat dairy products. DASH significantly lowers blood pressure. The decreases are often comparable to those achieved with blood pressure-lowering medication.
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