Recently, the American Heart Association and the American College of Cardiology jointly released new guidelines for the diagnosis and treatment of hypertension, commonly known as high blood pressure. These guidelines lower the blood pressure threshold an individual needs to meet to be considered hypertensive. Previously a blood pressure of 140/90 was the threshold. Now individuals with a blood pressure of 130/80 or more would be considered to have hypertension. Patients with a reading of 130/80 are considered stage 1 hypertension; patients with a reading of 140/90 or higher are considered to have stage 2 hypertension.
So what do these guidelines mean, realistically, for people watching their blood pressure?
Simply put, these guidelines still encourage adults to adopt lifestyle changes as part of the management of hypertension. Recommended lifestyle changes are different for everyone, but they may include weight loss, smoking cessation, decreasing salt intake and reducing alcohol consumption. However, unlike previous guidelines, it encourages the use of anti-hypertensive medications earlier than previously suggested to manage blood pressure. When to start anti-hypertensive therapy will depend on whether a patient has stage 1 or stage 2 hypertension. If the patient has stage 1 hypertension, the patient’s 10-year risk for cardiovascular events as determined by a risk calculator (known as the ASCVD risk calculator) will help guide the decision of whether blood pressure medications are appropriate. If a patient is found to have stage 2 hypertension, the recommendation is to adopt lifestyle changes and start medications.
The reason for these updates is directly linked to the prevention of more serious health consequences. High blood pressure is linked to cardiovascular disease, heart attacks, stroke and kidney failure. Decreasing one’s blood pressure can decrease the likelihood of these much more serious health problems. Because high blood pressure can be modified and lowered, the earlier people are aware of their risk for developing hypertension or their diagnosis of hypertension, the earlier they can begin the lifestyle changes and anti-hypertensive medications (if necessary) to keep high blood pressure at bay and prevent it from compounding into a more advanced condition. These guidelines may help physicians better identify those at risk for more serious health consequences so that patients can be proactive about their health.
These guidelines are, of course, just that—guidelines. Every individual is different, so how a patient and his or her provider choose to apply the guidelines will vary from individual to individual. If you’re concerned or have questions about your blood pressure and the steps you can be taking to lower it, talk to your provider. If would like to connect with a Prisma Health provider, call 1-844-447-3627 or visit ghs.org/providers.