it’s time to check your Blood pressure
New medical guidelines lower the threshold
dubai — A slight change in screening of the silent killer, high blood pressure, will improve the management of the condition with long term benefits, said health experts after the American Heart Association (AHA) lowered the threshold for high blood pressure by saying it should be treated at a reading of 130/80 mm Hg instead of the previous limit of 140/90.
A lot younger population in their 40s instead of the earlier 50s could be at risk with the change in the readings. The new guidelines say doctors now recognise that complications ‘can occur at those lower numbers’, in the first update to comprehensive US guidelines on blood pressure detection and treatment since 2003.
Paul Whelton, lead author of the guidelines published in the AHA journal, Hypertension, and the Journal of the American College of Cardiology, said, “It’s a yellow light that you need to be lowering your blood pressure, mainly with non-drug approaches.”
Associate Prof Dr Walid Shaker, consultant cardiothoracic surgeon at Burjeel Hospital in Abu Dhabi, said doctors would need to tell patients to modify their habits as early as they can as the damage to blood vessels can happen at the reading of 130/80.
“The UAE is always quick to adopt new guidelines and hopefully we will also do that soon,” he added. An earlier diagnosis of 130/80 had meant that patients were normal and could continue to follow the lifestyle that they were following, he explained.
He added that an early diagnosis does not mean that patients would need to take medication to control the condition but should lose weight, exercise more, eat healthier, avoid alcohol and salt, quit smoking and avoid stress. According to the new standards, nearly half (46 per cent) of the US population will be defined as having high blood pressure.
Previously, one in three (32 per cent) had the condition, which is the second leading cause of preventable heart disease and stroke, after cigarette smoking.
The normal limit for blood pressure is considered 120 for systolic, or how much pressure the blood places on the artery walls when the heart beats, and 80 for diastolic, which is measured between beats.
Once a person reaches 130/80, “you’ve already doubled your risk of cardiovascular complications compared to those with a normal level of blood pressure,” said Paul Whelton. “We want to be straight with people — if you already have a doubling of risk, you need to know about it.”
Damage to the blood vessels is already beginning once blood pressure reaches 130/80, said the guidelines, which were based in part on a major US-government funded study of more than 9,000 people nationwide. “People with those readings now will be categorised as having either elevated (120-129 and less than 80) or Stage I hypertension (130-139 or 80-89).” Medication is only recommended for people with Stage I hypertension “if a patient has already had a cardiovascular event such as a heart attack or stroke, or is at high risk of heart attack or stroke based on age, the presence of diabetes mellitus, chronic kidney disease or calculation of atherosclerotic risk.”
“I absolutely agree with the change in what is considered high blood pressure because it allows for early lifestyle changes to be addressed,” said Dr Satjit Bhusri, a cardiologist at Lenox Hill Hospital in New York.
“It is important, however, to realise that the change in the definition does not give course to increase prescription of medications, rather that it brings to light the need to make lifestyle changes,” Bhusri said in an email to AFP.
Certain groups, such as those with diabetes, should be treated if their top number is over 130, the guidelines say. For the rest, whether to start medication will no longer be based just on the blood pressure numbers. The decision also should consider the overall risk of having a heart problem or stroke in the next 10 years, including factors such as age, gender and cholesterol, using a simple formula to estimate those odds.
Those without a high risk will be advised to improve their lifestyles — lose weight, eat healthy, exercise more, limit alcohol, avoid smoking. “It’s not just throwing meds at something,” said one primary care doctor who praised the new approach, the Mayo Clinic’s Dr Robert Stroebel. If people continue bad habits, “They can kind of eat and blow through the medicines,” he said.
The guidelines warn about some popular approaches, though. There’s not enough proof that consuming garlic, dark chocolate, tea or coffee helps, or that yoga, meditation or other behaviour therapies lower blood pressure long-term, they say.
The new guidelines were announced at the American Heart Association’s 2017 Scientific Sessions conference in Anaheim, California.
(With inputs from agencies)
Jeff Sessions. —