New Guidelines for High Blood Pressure: What Do They Mean?

In the last two decades, high blood pressure has been a popular topic of conversation in the healthcare world and beyond. Known as the “silent killer,” high blood pressure can be a symptom of or a predecessor of many diseases and conditions, like heart disease, diabetes, and stroke.
The tissues and organs in your body need oxygenated blood to function. This blood is carried by your circulatory system, and when your heart beats, it creates a pressure that pushes the blood through networks of veins and arteries throughout your body. High blood pressure is when the force of this blood is too high. The damage from this can make the heart and blood vessels work too hard to accommodate the pressure, and may damage delicate tissues in your body. Over time, chronic high blood pressure may lead to heart attacks, stroke, diabetes, and other illnesses. Chronic high blood pressure puts you at risk for a variety of health issues.
Physicians test blood pressure by using a blood pressure monitoring device in the office. These machines can also be bought and used at home to monitor blood pressure more often. They may be manual or automatic depending on the physician. The blood pressure cuff is placed on a patient’s upper arm and it is slowly inflated to cut off blood flow. Then, the cuff slowly releases and registers the circulation pressure as it returns to the arm. This is how physicians and nursing assistants measure systolic and diastolic blood pressure.
Systolic blood pressure measures the pressure in your blood vessels when your heart beats, and diastolic blood pressure measures the pressure in your blood vessels when your heart rests. Regular blood pressure is a reading of 120 systolic and 80 diastolic, or “120 over 80”. Physicians and medical professionals use a scale of this reading to determine what level of blood pressure a patient has. A reading of 120/80 is considered a normal blood pressure level and is no cause for concern. A blood pressure of 140/90 is considered high blood pressure and anything in between is considered prehypertension or pre-high blood pressure.
These were the standards that physicians and medical professionals operated under for many years, and physicians prescribed medications and lifestyle changes based on the blood pressure range mentioned above. However, in 2017, the American College of Cardiology and the American Heart Association, in conjunction with nine other health professional organizations lowered the definition of prehypertension and high blood pressure. The new guidelines are:
Normal (remains the same): Less than 120/80 mm Hg.
Elevated: 120-120/less than 80 mm Hg
Stage 1: 130-39/80-89 mm Hg
Stage 2: 140/90 mm Hg
Hypertensive crisis: Over 180/over 120
These new guidelines indicate that the previous prehypertension and hypertension guidelines are given a more in-depth meaning, to hopefully help physicians and patients find preventative measures to take if a patient presents with any concerning high blood pressure reading. The sooner a physician can diagnose a blood pressure issue, the sooner steps can be taken for lifestyle changes or medication changes in order to prevent further damage to arteries and veins.
The new set of guidelines can help patients recognize where they are on the “blood pressure danger” scale and take appropriate measures earlier to keep their blood pressure under control. By the new set of standards, nearly half of the U.S. adult population now has what is considered elevated high blood pressure, and hypertension rates among adult men under 45 is expected to triple. Only a small number of people will be medicated under these new guidelines, however—physicians have their own set of guidelines for when to prescribe anti-hypertension medications to a patient. The guidelines also take into account “white coat syndrome,” a psychological condition in which blood pressure rises when medical tests are being performed, and encourage patients to purchase at-home blood pressure monitors to keep an eye on their blood pressure in the comfort of their own home.
Maintaining a healthy blood pressure regardless of guidelines is still a good idea, however. The “normal” range of blood pressure still remains 120/80, and there are several ways that patients can help lower their risk of developing this condition. Healthy habits like daily moderate exercise, eating less sodium in the diet, reducing stress and taking all prescribed medications are great ways to reduce blood pressure or maintain normal levels.
Dr. Gildardo Ceballos
Internal Medicine
OakBend Medical Group
Disclaimer: The contents of this article, including text and images, are for informational purposes only and do not constitute a medical service. Always seek the advice of a physician or other qualified health professional for medical advice, diagnosis, and treatment.
Resources:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1121444/
http://www.acc.org/latest-in-cardiology/articles/2017/11/08/11/47/mon-5pm-bp-guideline-aha-2017