The nation’s heart experts tightened the guidelines for high blood pressure Monday, a change that will sharply increase the number of U.S. adults considered hypertensive in the hope that they, and their doctors, will address the deadly condition earlier.
Acting for the first time in 14 years, the American Heart Association and the American College of Cardiology redefined high blood pressure as a reading of 130 over 80, down from 140 over 90. The change immediately means that 46 percent of U.S. adults, many of them under the age of 45, now are considered hypertensive. Under the previous guideline, 32 percent of U.S. adults had high blood pressure.
But the report’s authors predicted that relatively few of those who fall into the new hypertensive category will need medication. Rather, they hope, that many found with the early stages of the condition will be able to address it through lifestyle changes such as improving their diet, getting more exercise and lowering stress.
"An important cornerstone of these new guidelines is a strong emphasis on lifestyle changes as the first line of therapy. There is an opportunity to reduce risk without necessarily imposing medications," Richard Chazal, the immediate past president of the American College of Cardiology, said.
The new guidelines will be influential in clinical practice, with most health care providers expected to follow the recommendations of research-based recommendations from leading voices in cardiovascular medicine. In addition to tightening the definition of high blood pressure, the new report does away with the old category of "pre-hypertension," which was defined as a top (systolic) reading of 120 to 139 or a bottom (diastolic) number between 80 and 89.
"We’re recognizing that blood pressures that we in the past thought were normal or so-called ‘prehypertensive’ actually placed the patient at significant risk for heart disease and death and disability," said Robert M. Carey, co-chairman of the new report. "The risk hasn’t changed, what’s changed is our recognition of the risk."