The New Blood Pressure Guidelines

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The New Blood Pressure Guidelines

If you didn’t have high blood pressure last week, you may have it now. Even if your blood pressure hasn't changed one bit.

Say what?

Unfortunately, yes. That’s because earlier this week, the American College of Cardiology (ACC) and the American Heart Association (AHA) released new, more aggressive guidelines for the detection, prevention, management, and treatment of high blood pressure.

The guidelines, which had not been updated for 14 years, redefine high blood pressure as a reading of 130/80 mmHg, down from 140/90. It also eliminated the “pre-hypertension” category, which had been an upper reading in the 120 to 139 range and a lower reading from 80 to 89.

For these new guidelines, the ACC and AHA assembled a panel of 21 scientists and health experts who reviewed more than 900 published studies. The update means that nearly half the adult population in this country now have high blood pressure.

Yes, you read that right. Nearly half of all adults now have high blood pressure.

The population most affected? Younger folks. This new definition triples the number of men and doubles the number of women under 45 who now have high blood pressure.

What now?

If you’re one of those who now has high blood pressure, put your hands in the air and step away from the panic button. Experts are not jumping to prescription drug treatment right away. Instead, the first steps they recommend are to lose weight, tweak your dietmove more, and make other lifestyle changes.

The diet many experts recommend to lower blood pressure is called the DASH diet (Dietary Approaches to Stop Hypertension). DASH guidelines include whole grains, poultry, fish, and nuts, as well as low amounts of fats, red meats, sweets, and sugared beverages. The diet is high in potassium, calcium, and magnesium, as well as protein and fiber. Eating foods lower in salt and sodium can also reduce blood pressure.

Unfortunately, some people may find the DASH diet difficult to follow because of its fat and sodium restrictions. Never fear! Our favorite diet, the Mediterranean Diet, is quite similar, with no measuring, mixing, counting, or depriving. A Mediterranean-style diet encourages you to eat, just eat more wholesome foods. Think whole foods that have been minimally processed to retain their nutrient content.

In fact, in his book, Good Food, Great Medicine, our friend, author Miles Hassell, MD, notes that in his practice, the Mediterranean model works as well, has better overall outcomes data, and is easier for most people to follow than the DASH diet.

To recap:

The new guidelines put blood pressure readings in five different categories:

  • Normal. A top number less than 120 AND a bottom number less than 80.

  • Elevated. A top number between 120 and 129 AND a bottom number less than 80.

  • Stage 1. A top number between 130 and 139 OR a bottom number between 80 and 89.

  • Stage 2. A top number of 140 or higher OR a bottom number of 90 or higher.

  • Hypertensive crisis. A top number over 180 OR a bottom number over 120. 

The guidelines also stress the importance of using proper technique to measure blood pressure, and instruct exactly how to check blood pressure both in the healthcare office and at home. Before being diagnosed with high blood pressure you need to have at least two readings done on at least two separate occasions.

This helps avoid any misdiagnosis due to “white-coat hypertension,” the temporary increase in blood pressure that befalls some people who get anxious at doctor’s visits. Patients are also urged to take regular readings at home to confirm the diagnosis.

Now you have even more motivation to eat right, exercise more, and put that salt shaker away!

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