Until recently high blood
pressure was defined as blood pressure (BP) persistently above 140 mm Hg
systolic or 90 mm Hg diastolic, but according to the 2017 hypertension guideline from a joint task force by the American College of
Cardiology (ACC) and the American Heart Association (AHA), based on a review of
almost 1,000 studies redefined high BP as readings persistently above 130 over 80
mm Hg which is now defined as hypertension. The new guideline is meant to prevent
strokes, heart attacks, heart and kidney failure through lifestyle changes such
as eating a healthy diet, exercising, reducing salt intake, loosing weight if
overweight and taking antihypertensive medications if needed.
The ACC/AHA guideline provides
four categories of BP, ranging from normal to stage II hypertension, as shown in
the image above. The guidelines, which
were published in the Journal of the American College of Cardiology, prescribe exactly how blood pressure should
checked. Physicians and nurses are urged
to let patients rest five minutes first and then to average at least two
readings over two separate visits.
Meanwhile, patients are urged to take regular readings at home, with a
device checked out by their health care providers. The
four categories are based on average BP measurements and for individuals with an
abnormal systolic BP and diastolic BP, the designation should go to the higher
category. To confirm a new diagnosis of hypertension, an out-of-office in the
patient’s house confirmation of elevated BP is strongly suggested as the “white
coat” high BP can wrongly categorize someone as having hypertension.
Based on the new guideline
46 percent of US adults, many of them under the age of 45, will now be
considered hypertensive while under the previous guideline, 32 percent of US
adults had hypertension.
