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The nation’s leading heart experts on Monday issued new guidelines for high blood pressure that mean tens of millions more Americans will meet the criteria for the condition, and will need to change their lifestyles or take medicines to treat it.
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Cardiovascular disease remains the leading cause of death among Americans. The new criteria, the first official diagnostic revision since 2003, result from growing evidence that blood pressure far lower than had been considered normal greatly reduces the chances of heart attack and stroke, as well as the overall risk of death.
The investigators assigned more than 9,300 men and women ages 50 and older who were at high risk of heart disease to one of two targets: a systolic pressure (the higher of the two blood pressure measures) of less than 120, or a systolic pressure of less than 140.
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Even under the relatively more lenient standard that had prevailed for years, close to half of patients did not manage to get their blood pressure down to normal.
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“Is it going to affect a lot of people, and is it going to be hard to meet those blood pressure goals?” asked Dr. Raymond Townsend, director of the hypertension program at Penn Medicine. “The answer is a pretty significant yes.”
Blood pressure of 130 is the new 'high ..
Now, high blood pressure will be defined as 130/80 millimeters of mercury or greater for anyone with a significant risk of heart attack or stroke. The previous guidelines defined high blood pressure as 140/90. (The first number describes the pressure on blood vessels when the heart contracts, and the second refers to the pressure as the heart relaxes between beats.)
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If Americans act on the guidelines and lower their blood pressure by exercising more and eating a healthier diet, or with drug therapy, they could drive an already falling death rate from heart attacks and stroke even lower, experts said.
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Few risk factors are as important to health. High blood pressure is second only to smoking as a preventable cause of heart attacks and strokes, and heart disease remains the leading killer of Americans.
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It’s true, he said, that doctors ought to be more aggressive in treating people at high risk. But, he added, “If a patient comes in with a blood pressure of 180, I will not get him to 130.”
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