New Blood Pressure Guidelines

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.