Blood pressure guidelines are causing confusion
DEAR DOCTOR: I’m so confused by the new blood pressure guidelines. Yesterday, my blood pressure was normal. With the new guidelines, though, I’m now considered to have high blood pressure. Is my doctor going to put me on medication?
DEAR READER: Blood pressure goals have long been controversial among the medical com- munity. In 2014, when a panel of medical experts loosened blood pressure guidelines for some older Americans, there was an immediate backlash. Now, since the American College of Cardiology and the American Heart Association tightened guidelines in November, the debate has erupted again.
Heart disease, which accounts for one quarter of all deaths in the United States, is the leading cause of death among both women and men. High blood pressure, or hypertension, is second only to smoking as a preventable cause of heart attack and stroke. At this time, guidelines state that normal blood pressure falls into a range below 120/80. The top number, known as systolic pressure, refers to the pressure in your arteries as your heart contracts. The bottom number is diastolic pressure, which is the pressure in your arteries between heartbeats. When taken together, the numbers offer a snapshot of your cardiac health.
People with a top number that falls between 120 and 129, and whose bottom number falls below 80, are considered to have “elevated” blood pressure. A top number of 130 to 139, and a bottom number of between 80 and 89, is considered to be stage 1 high blood pressure. Readings greater than 140/90 are stage 2 high blood pressure. Both stage 1 and 2 require medication.
Part of the uproar over these new guidelines is they are likely to push close to half of all Americans out of the normal range. However, this doesn’t automatically mean blood pressure medication for everyone. Because it has no obvious symptoms, high blood pressure is known as the silent killer. By catching changes early, people with elevated blood pressure can take steps to achieve healthier numbers through lifestyle changes and interventions.
Therefore: Lose weight. Stop smoking. Exercise regularly. Watch your diet. Cut back on salt. Limit alcohol. Cut back on caffeine. Reduce stress.