New Blood Pressure Standards Sound Alarm This Heart Month

About a week before Thanksgiving, the percentage of Americans with high blood pressure - also known as hypertension - leaped to 45 percent from 30 percent.

Last fall, a “silent killer” advanced on a growing number of Americans.

About a week before Thanksgiving, the percentage of Americans with high blood pressure – also known as hypertension – leaped to 45 percent from 30 percent. 

The dramatic increase came when the American Heart Association (AHA) and the American College of Cardiology (ACC) revised the guidelines regarding the criteria for high blood pressure. The new standards are expected to triple the number of men under 45 considered to have high blood pressure, and double the number of women under 45. In terms of population, it means that 103.3 million Americans are now classified as having high blood pressure, up from 72.2 million. 

“Those numbers are alarming,” says Dr. Nabil Dib, director of cardiovascular research for Dignity Health in Arizona.  “But that may be a good thing in the long run, because too many people ignore high blood pressure. The new guidelines have sparked a national conversation on high blood pressure and its threat to the health of millions of Americans.”

High blood pressure has been dubbed a “silent killer” because it often presents little to no warning signs.  But it doubles your risk of cardiovascular complications like heart failure, stroke, coronary artery disease, atrial fibrillation, and peripheral vascular disease. This is even more important if the patient has risk factors like smoking and high cholesterol, or other medical conditions like diabetes.. 

“Many of my patients ask, ‘What is blood pressure?’ Simply put, blood pressure is the pressure of circulating blood on the walls of blood vessels” say Dr. Dib.  Blood pressure is measured using two numbers. The first number, called “systolic” blood pressure, measures the pressure in your blood vessels when your heart beats. The second number, called “diastolic” blood pressure, measures the pressure in your blood vessels when your heart rests between beats. If the measurement reads 120 systolic and 80 diastolic, a person’s blood pressure reading would be 120 over 80.

Here are the blood pressure categories in the new guideline, and their treatments:

• Normal: Less than 120/80;
• Elevated: Systolic between 120-129 and diastolic less than 80 (lifestyle changes like diet and exercise);
• Stage 1: Systolic between 130-139 or diastolic between 80-89 (needs medical therapy);
• Stage 2: Systolic more than 140 or diastolic more than 90 mm Hg (may need two or more medications);
• Hypertensive crisis: Systolic over 180 and/or diastolic over 120, (patient needs prompt changes in medication, or immediate hospitalization if there are signs of organ damage). 

“I think it is important to mention the impact that research has in producing new guidelines and standards of care,” says Dr. Dib. “The new ACC/AHA guidelines were developed with nine other professional health organizations and were written by a panel of 21 scientists and health experts who reviewed more than 900 published research studies. I believe that this research, and the information gathered from clinical trials, will help doctors improve people’s health and their lives.”

Dr. Dib says that when doctors diagnose a patient with high blood pressure, they can educate them sooner about lifestyle changes like diet and exercise, or possibly the need for medication, which may reduce their risk of cardiovascular complications.