American Heart Association Revises High Blood Pressure Parameters

The American Heart Association (AHA) and the American College of Cardiology recently revised their current guidelines for high blood pressure. The new guidelines suggest that high blood pressure should be treated earlier with lifestyle changes and medication at 130/80 mm Hg rather than 140/90 mm Hg, according to a press release.

The previous guidelines indicated that 1 in 3 Americans had high blood pressure, but the revisions suggest that nearly half of the population has the condition. However, the AHA reports that there will not be a significant uptick in patients treated with anti-hypertensive drugs under the new guidelines.

The guidelines provide a needed update to the 2003 version and help address the condition earlier to prevent adverse events, according to the release.

The AHA said that the guidelines also stress the importance of properly measuring blood pressure. Blood pressure should be the average of 2 to 3 readings on 2 or more occasions, according to the guidelines.

High blood pressure is responsible for a significant number of preventable heart disease- and stroke-related deaths. Many individuals are unaware of the condition since it may not elicit symptoms.

The authors said that the revised guidelines now account for the dangers associated with blood pressure levels between 130-139/80-89-mm HG, according to the release.

“You’ve already doubled your risk of cardiovascular complications compared to those with a normal level of blood pressure,” said lead author of the guidelines Paul K. Whelton, MB, MD, MSc. “We want to be straight with people—if you already have a doubling of risk, you need to know about it. It doesn’t mean you need medication, but it’s a yellow light that you need to be lowering your blood pressure, mainly with non-drug approaches.”

The new blood pressure categories are:

Normal: Less than 120/80 mm Hg.

Elevated: Systolic between 120 and 129 mm Hg and diastolic less than 80 mm Hg.

Stage 1: Systolic between 130 and 139 mm Hg or diastolic between 80 and 89 mm Hg.

Stage 2: Systolic at least 140 mm Hg or diastolic at least 90 mm Hg.

Hypertensive crisis: Systolic over 180 mm Hg and/or diastolic over 120 mm Hg, with patients requiring medication changes.

The guidelines also eliminate the prehypertension category and patients with systolic blood pressure between 120 to 139 mm HG or diastolic between 80 to 89 mm Hg will now be classified as having elevated blood pressure or stage 1 hypertension, according to the AHA.

The authors believe that the new guidelines will have the greatest impact on younger individuals since high blood pressure is expected to triple among younger men and double among younger women.

“If you’re only going to focus on events, that ignores the process when it’s beginning,” Dr Whelton said. “Risk is already going up as you get into your 40s.”

Other changes to guidelines include:

• Prescribing medication for stage I hypertension if a patient has experienced a cardiovascular event or is at high risk of heart attack or stroke based on age, diabetes, chronic kidney disease, or atherosclerotic risk.
• Understanding patients may need multiple medications to control their blood pressure and the merits of prescribing a combination pill.
• Identifying socioeconomic status and stress as risk factors.

Additionally, the National Institutes of Health (NIH) announced that data from the Systolic Blood Pressure Intervention Trial (SPRINT) supported the need for revised guidelines.

The SPRINT study included more than 9300 patients and examined how to keep blood pressure at a lower rate than guidelines suggested would affect heart and kidney disease, according to a press release.

The NIH said that implementing these new guidelines will lead to improved health and lower risks of heart disease and stroke.