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New ACC/AHA High Blood Pressure Guidelines Lower Definition of Hypertension

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  • New ACC/AHA High Blood Pressure Guidelines Lower Definition of Hypertension

    New standards for the definition of high blood pressure were announced this week by The American College of Cardiology and the American Heart Association. The 2003 standards of 140/90 for high blood pressure have been lowered to 130/80. That now means that nearly half the people in the US will be diagnosed as having high blood pressure. People above 130-139/80-89 are already at double the risk for a heart attack of someone with normal blood pressure.

    The new guidelines stress that diet, exercise, lifestyle and self-monitoring should be used rather than medications.

    Blood pressure categories in the new guideline are:
    • Normal: Less than 120/80 mm Hg;
    • Elevated: Systolic between 120-129 and diastolic less than 80;
    • Stage 1: Systolic between 130-139 or diastolic between 80-89;
    • Stage 2: 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.
    Here is the full story.

  • #2
    This is a relief and major improvement for those of us treating this condition. It's been hard to get a patient's attention when their BP is 125 systolic or 85 diastolic. Yet many people are there. It's always easier to "cross that bridge when I get to it". With the standards at 130/90, they didn't think they were there yet. But they were.


    • Robin
      Robin commented
      Editing a comment
      I've always had low BP... 110/70... but now mine is consistently 124/82-4... And I have only improved my already good lifestyle habits...but yes I am now 55. Still 5'5 3/4" and 126lbs. Exercise everyday... so now I think something is amiss. But I'm working with Dr. Brewer and I know I can resolve this.

  • #3
    As to be expected, the American Academy of Family Physicians has decided not to endorse the new recommendations of the ACC and AHA. They choose to adhere to the old standards of 140/90 and won't initiate high blood pressure treatment for a patient age 60 or older unless their systolic BP is 150 or over. All I can say is WOW!
    After a rigorous review, the AAFP has chosen to not endorse the recent hypertension guideline from the American Heart Association, the American College of Cardiology and nine other health professional organizations.


    • #4
      Not saying its a bad thing as it will certainly bring it to the patients attention that it needs to addressed, but it does sound a bit like the statin story!


      • #5
        I think the blood pressure standards needed to be lowered as do the guideline levels for blood glucose.


        • #6
          I agree, but sadly it will mean more medications for most folks, which won't correct the problem.


          • #7
            Yes, if we all clean up our acts with diet and lifestyle we can reduce the need for medication, but we will not eliminate the need for medications in every case.


            • #8
              Thats the dilemma the Dr faces, so many today will never change their ways even when facing serious challenges. I see it in case after case, the public want someone to fix them, they dont want to know how to stop or reverse the damage. I was no different until I realised just how serious a poor diet/lifestyle effects the body!


              • #9
                Yes. Lifestyle is critical. Sometimes, especially as we age, we need help from meds. But they should not be a replacement for a healthy lifestyle. Unfortunately, too many use them that way.


                • #10
                  Do you know if these free blood pressure machines at drug stores and drug counters do a decent job?


                  • #11
                    Welcome, Ed. Great question. I've heard they are, but after walking from your car and around the store your BP could be elevated. It's best to be seated, relaxed and have your arm out horizontal at 90 degrees. Try it out by taking 3 measurements a minute apart and see if you can get some readings where the they are relatively close, let's say +/- 5 mm/Hg each time. Stay seated and relaxed while doing it. That will at least show they are repeatable.

                    I prefer home monitoring. Good machines like Omron only cost about $30 to $65 and they are quite accurate and repeatable.

                    This is the one I use and I like it a lot.



                    • #12
                      John Lorscheider , How low a BP would be optimal in youth, middle age, and old age, respectively?


                      • #13
                        That is a really good question. The recommendations are all over the board. It all depends on who we choose to listen to. It's pretty safe to say that 120/80 or below is healthy for most everyone over the age of 10. I keep mine at or around 115/65-70. Some doctors don't consider it a treatable condition until a person is over 140/90.

                        Sometimes doctors let the range increase for the elderly to avoid hypotension episodes and potential falls.

                        Here is an age stratified blood pressure chart you may find interesting.


                        • #14
                          John Lorscheider , I like the chart, but wonder about allowing it to rise so much in older age. Also that website references studies by only the Med school that might have done them, very unfortunate.

                          I wonder if the insurance companies have "real statistical" data for BP.

                          After hours of searching, having found very little, I do see where your number of 115 may have come from:

                          Page 75 and with charts on Page 77

                          They cite:

                          Which deals with Diastolic BP. Seems 75 might be good.
                          Actually the claim that "prehistic values" were 110/70 on average!

                          They also site this, but I can't get a full text on this:


                          • #15
                            Here are some other references the WHO report references with regard to BP, but I have not reviewed them:

                            16 World Health Organization (2000). The World Health Report 2000 – Health systems: improving performance.
                            Geneva, World Health Organization.
                            17 Mathers CD, Sadana R, Salomon JA, Murray CJL, Lopez AD (2001). Healthy life expectancy in 191
                            countries, 1999. Lancet, 357(9269): 1685-1691.
                            18 Mathers CD, Murray CJL, Lopez AD, Salomon JA, Sadana R, Tandon A, Üstün TB, Chatterji S. (2001).
                            Estimates of healthy life expectancy for 191 countries in the year 2000: methods and results. Geneva, World
                            Health Organization (GPE discussion paper No. 38).