130/80 is new high for blood pressure
ANAHEIM, CALIFORNIA— The American Heart Association says high blood pressure should be treated sooner “when it reaches 130/80mmHg, not the previous limit of 140/90.” Doctors now recognize that complications “can occur at those lower numbers.” Once a person reaches 130/80, they have already doubled the risk of cardiovascular complications compared to those with normal level of blood pressure.
ANAHEIM, CALIFORNIA— High blood pressure has been redefined by the American Heart Association, which said the disease should be treated sooner—when it reaches 130/80 mm Hg, not the previous level of 140/90.
Doctors now recognize that complications “can occur at those lower numbers,” said the first update to comprehensive US guidelines on blood pressure detection and treatment since 2003.
A diagnosis of the new high blood pressure does not necessarily mean a person needs to take medication, but that “it’s a yellow light that you need to be lowering your blood pressure, mainly with nondrug approaches,” said Paul Whelton, lead author of the guidelines published on Monday in the American Heart Association journal, Hypertension, and the Journal of the American College of Cardiology.
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.
Double the risk
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,” Whelton said.
The new standard means that nearly half (46 percent) of the US population will be defined as having high blood pressure.
Previously, one in three (32 percent) had the condition, which is the second leading cause of preventable heart disease and stroke, after cigarette smoking.
Poor diets, lack of exercise and other bad habits cause 90 percent of high blood pressure.
Currently, only half of Americans with high blood pressure have it under control.
The upper threshold for high blood pressure has been 140 since 1993, but a major study two years ago found heart risks were much lower in people who aimed for 120. Canada and Australia lowered their cutoff to that; Europe is still at 140 but is due to revise its guidelines next year.
The guidelines, announced on Monday at an American Heart Association conference in Anaheim, set new categories and got rid of “prehypertension”: Normal: Under 120 over 80 Elevated: Top number 120-129 and bottom less than 80
Stage 1: Top of 130-139 or bottom of 80-89
Stage 2: Top at least 140 or bottom at least 90
How common hypertension is will roughly triple in men under 45, to 30 percent, and double in women of that age, to 19 percent.
For people over 65, the guidelines undo a controversial tweak made three years ago to relax standards and not start medicines unless the top number was over 150.
Now, everyone that old should be treated if the top number is over 130 unless they’re too frail or have conditions that make it unwise.
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, and avoid smoking.
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 behavior therapies lower blood pressure in the long term.