Half of USA adults have high blood pressure under new guidelines

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In the first change to blood pressure guidelines in 14 years, the American Heart Association and the American College of Cardiology say that the threshold for high blood pressure should be lower.

According to a release from the AHA, patients with a blood pressure reading of 130/80 should now be considered to have hypertension, or abnormally high blood pressure.

Americans will be getting instructions on how to check their blood pressure every day to keep up with how they are doing. And thirdly, we set lower blood pressure targets during treatment. This added pressure causes the heart to work too hard and blood vessels to function less effectively.

Joaquin E. Cigarroa, MD, the head of the division of cardiovascular medicine at Oregon Health and Science University, said 70 percent of the people now recognized at increased risk can be treated with nutrition and lifestyle changes alone.

For the past 14 years, high blood pressure has been defined as 140/90, and approximately one in every three people in the USA are now diagnosed under this measurement.

Ferdinand said he hopes the new guidelines will push clinicians to treat patients earlier on, which could reduce the number of cardiac-related deaths, specifically heart attack and stokes.

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Under the new guidelines, 120 or less is still normal blood pressure, but up to 129 is considered elevated. High blood pressure can stress vessels and cause them to be less elastic, which can increase the risk of heart disease and stroke. In addition to tightening the definition of high blood pressure, the new report does away with the old category of "pre-hypertension", which was defined as a top (systolic) reading of 120 to 139 or a bottom (diastolic) number between 80 and 89. The guidelines point out that patients with Stage 1 high blood pressure (130-139/80-89 mm Hg) who also have other issues that increase their risk for heart attack and stroke, such as diabetes, should start medication while also working on lifestyle changes. Prescriptions for blood pressure drugs are not expected to leap under the guidelines, experts said. The prevalence of high blood pressure is expected to triple among men under age 45 and double among women under 45.

Of the estimated 14 percent more adults to be classified with high blood pressure, about one in five will need medication, according to Paul Whelton, M.D., who chaired the guideline writing committee. "Normal hasn't changed. We are still saying that it is great and it is normal to have a systolic blood pressure reading below 120 and a diastolic reading under 80", Whelton said.

Still, only about half of Americans with hypertension under the old guidelines have it under control, said Whelton, the guideline chair.

The new guidelines "take advantage of evidence nearly up to the minute, so they are very current", Whelton said. The studies were reviewed by 52 experts who submitted close to 1,000 questions, and approved by 11 partnering medical organizations. The lower number is the diastolic reading, or the pressure level between the contractions when the heart is filling with blood.

Stage 2: Systolic of 140 or higher. Ferdinand is a professor of Clinical Medicine at the Tulane University Heart and Vascular Institute and said rates of hypertension are even higher in the South than in other parts of the country.

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