The nation's heart experts tightened the guidelines for high blood pressure Monday, a change that will sharply increase the number of US adults considered hypertensive in the hope that they, and their doctors, will address the deadly condition sooner.
The guidelines, often referred to as the 2017 Hypertension Clinical Practice Guidelines, will update and replace the 2003 guidelines published by the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure.
Now one-third of Americans are considered to have high blood pressure.
A doctor speaks to a patient as a sphygmomanometer, or blood pressure meter, lies on his desk.
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Damage to blood vessels begins soon after blood pressure is elevated, said Whelton, who is the Show Chwan professor of global public health at Tulane University School of Public Health and Tropical Medicine and School of Medicine in New Orleans. Writing down these readings at home can help tell the difference between people with truly abnormal blood pressure and those with "white-coat syndrome" - with high blood pressure only under stress like at the doctor's office.
The new guidelines also emphasize the importance of accurate blood pressure measurements, using an average of different readings at different times.
The rest of those at risk under the new guidelines will be urged to reduce their blood pressure through lifestyle changes - losing weight, eating healthful foods, cutting down on salt, increasing potassium-rich foods, exercising regularly and moderating their drinking, said Dr.
The changes are expected to drastically impact adult Americans: revising the hypertension threshold downward will increase the percent of US adults living with high blood pressure from 32 percent to 46 percent - almost half of the adult population. 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 prevalence of high blood pressure is expected to triple among men under age 45, and double among women under 45 according to the report. They found that the lower the blood pressure, the better the health outcomes. Prescriptions for blood pressure drugs are not expected to leap under the guidelines, experts said. She is medical director of Heart Failure and Cardiac Transplantation at St. Vincent Heart Center of Indiana.
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The new guidelines incorporate data from the Systolic Blood Pressure Intervention Trial (SPRINT), which was a large, randomized controlled trial created to assess the impact of more aggressive versus standard blood pressure goals on hard cardiovascular outcomes. The studies were reviewed by 52 experts who submitted close to 1,000 questions, and approved by 11 partnering medical organizations.
The new classifications and recommendations are specific in how they determine who is at risk and what they should do about it, Jamerson said.
Stage 1: Systolic between 130 and139.
Diastolic pressure - between heartbeats - should be below 80.
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Stage 2: Systolic of 140 or higher. Only those who have other factors that put them at risk of heart disease should be given medication, said Robert Carey, professor of medicine at the University of Virginia School of Medicine.