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What Is The Implication Of New Blood Pressure Guidelines? Hypertension or high blood pressure refers to a condition in which the blood pumped around the body is at too high pressure. It is often linked to unhealthy lifestyle habits, such as smoking, drinking too much alcohol, being overweight, and not exercising enough. Blood pressure is measured in mmHg and is taken using 2 measurements: systolic (measured when the heart beats, when blood pressure is at its highest) and diastolic (measured between heart beats, when blood pressure is at its lowest). Keeping blood pressure in check is paramount because it would affect the heart health. High blood pressure is a major risk factor for premature heart disease, stroke, heart attacks, heart failure, and even dementia. Normal blood pressure should be kept less at 120/80 mmHg or less. In 2017, new guidelines introduced by the American College of Cardiology (ACC) and the American Heart Association (AHA) state that a person is considered having high blood pressure if the blood pressure is 130/80mmHg. These new guidelines, which appeared in an article published in November 2017 in the ‘Journal of the American College of Cardiology’, were developed with 9 other health professional organizations.
Under the new guidelines, normal blood pressure:
less than 120/80 mmHg; elevated: systolic between 120 and 129 and diastolic less
than 80; stage 1 hypertension: systolic between 130 and 139 or diastolic between
80 and 89; stage 2 hypertension: systolic at least 140 or diastolic at least 90
mmHg; hypertensive crisis: systolic over 180 or diastolic over 120, which
requires prompt changes in medication if there are no other indications of
problems, or immediate hospitalization if there are signs of organ damage.
46 percent of Americans are effectively placed above the threshold for what is considered safe by the new guidelines. Before this, only 1 in 3 American adults, or 33 percent of the population, were considered to have high blood pressure, which was then defined as a blood pressure reading of 140/90 mmHg. Does it mean that the new guideline will put more people on medication? No, the doctors will only prescribe medication only if their patients actually have high blood pressure. In general, blood pressure fluctuates throughout the day, especially when one is active or nervous. For instance, it is common for patients to have elevated blood pressure readings in their doctor’s office. This is referred to as ‘white coat hypertension’. Should the patients’ systolic blood pressure be between 120 and 129, doctors would normally advise their patients to change some of their health behaviors, say managing weight and adopting healthy diet. For patients having systolic blood pressure between 130 and 139 or who are at increased risk for heart disease, the doctors may consider treating their high blood pressure with medication. Doctor may wait until the blood pressure reaches 140 or above to treat people with relatively uncomplicated high blood pressure. In many cases, the goal is to bring the blood pressure down to 120 or below with lifestyle changes and medication when appropriate. Nevertheless, the new guideline draws criticism on how to best treat older adults with high blood pressure. It is indeed very challenging for doctors to bring the systolic blood pressure down to 120 for an older patient whose systolic blood pressure is over 170. Anyway, lowering the blood pressure to 150 or even 145 can still have some benefits. In an article published in March 2017 in the journal ‘Annals of Internal Medicine’, the American College of Physicians and the American Academy of Family Medicine recommended that doctors should begin treatment when persistent systolic blood pressure is at or above 150 mmHg, to achieve a target systolic blood pressure of less than 150 mmHg. By doing so, it lowers the risk of mortality, stroke, and cardiac events as indicated by high-quality evidence.
The new guidelines also highlight
nonpharmacological ways to lower blood pressure. These include weight loss for
those who are overweight and obese; a healthy diet; sodium reduction;
By the way, a study published online November 19,
2018 in journal ‘Circulation’ predicted that the new blood pressure guidelines
could prevent more than 3 million cardiovascular disease events over 10 years. Date: October 1, 2020
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