Do you have high blood pres­sure? Un­der new guide­lines, nearly half of adults do

Richmond Times-Dispatch - - FRONT PAGE -

The na­tion’s heart ex­perts tight­ened the guide­lines for high blood pres­sure Mon­day, a change that will sharply in­crease the num­ber of U.S. adults considered hy­per­ten­sive in the hope that they, and their doc­tors, will ad­dress the deadly con­di­tion sooner.

Act­ing for the first time in 14 years, the Amer­i­can Heart As­so­ci­a­tion and the Amer­i­can Col­lege of Car­di­ol­ogy re­de­fined high blood pres­sure as a read­ing of 130 over 80, down from 140 over 90. The change means that 46 per­cent of U.S. adults, many of them un­der the age of 45, now will be considered hy­per­ten­sive. Un­der the pre­vi­ous guide­line, 32 per­cent of U.S. adults had high blood pres­sure.

“We’re rec­og­niz­ing that blood pres­sures that we in the past thought were nor­mal or so-called ‘pre-hy­per­ten­sive’ ac­tu­ally placed the pa­tient at sig­nif­i­cant risk for heart dis­ease and death and dis­abil­ity,” said Robert M. Carey, cochair­man of the group that pro­duced the new re­port. “The risk hasn’t changed. What’s changed is our recog­ni­tion of the risk.”

But the re­port’s au­thors pre­dicted that rel­a­tively few of those who fall into the new hy­per­ten­sive cat­e­gory will need med­i­ca­tion. Rather, they hope that many found with the early stages of the con­di­tion will be able to ad­dress it through life­style changes such as im­prov­ing their diet and get­ting more ex­er­cise.

The new guide­lines will be in­flu­en­tial in clin­i­cal prac­tice, with most health care providers ex­pected to fol­low the re­search­based rec­om­men­da­tions from lead­ing voices in car­dio­vas­cu­lar medicine. In ad­di­tion to tight­en­ing the def­i­ni­tion of high blood pres­sure, the new re­port does away with the old cat­e­gory of “pre­hy­per­ten­sion,” which was de­fined as a top (sys­tolic) read­ing of 120 to 139 or a bot­tom (di­as­tolic) num­ber be­tween 80 and 89.

“An im­por­tant cor­ner­stone of these new guide­lines is a strong em­pha­sis on life­style changes as the first line of ther­apy. There is an op­por­tu­nity to re­duce risk with­out nec­es­sar­ily im­pos­ing med­i­ca­tions,” said Richard Chazal, for­mer pres­i­dent of the Amer­i­can Col­lege of Car­di­ol­ogy.

In­stead, the guide­lines cre­ate new cat­e­gories of blood pres­sure, in­clud­ing “el­e­vated,” “Stage 1 and 2 hyper­ten­sion,” and “hy­per­ten­sive cri­sis,” each char­ac­ter­ized by var­i­ous blood pres­sure read­ings. Nor­mal blood pres­sure still will be considered 120 over 80.

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