New blood pressure guidelines mean almost half of U.S. adults have hypertension

Nov 14, 2017

Credit freeimages.com/Karen Barefoot

New medical guidelines lower the threshold for high blood pressure.

High pressure has long meant a reading of at least 140 over 90. That drops to 130 over 80 in the new guidelines announced by the American Heart Association and other health professional organizations.

This means nearly half of American adults have the condition. Dr. John Bisognano, a cardiologist at UR Medicine and president of the American Society of Hypertension, said the change comes with mounting evidence that it's worth treating people for hypertension at the lower end of the spectrum.

"If somebody in their mid-forties comes in with a blood pressure of 128, we used to just wait around until it reached a magic number of 140, as if something special happens once they're at 141,” he said. “But in fact, if they're at 128, we know what pathway they're on.  They've sort of merged onto a moving sidewalk toward a destination."

High blood pressure can increase the risk for heart attack, stroke, kidney disease and heart failure.

Doctors say only 2 percent of these newly added people need medication. The rest are urged to try healthier lifestyles first. That includes a lower sodium diet, more physical activity, and weight loss if they are overweight.

Bisognano said for some people, there is a stigma associated with high blood pressure.

"We have to decriminalize hypertension. People shouldn't feel badly that they have hypertension. It's not just their stress, it's not the anxiety; they shouldn't consider it as a personal insult. It's just something they have. It's like being bald, or having a little arthritis."

For those patients who need medication to treat their high blood pressure, Bisognano  said we're living in the golden age of generic drugs. They are inexpensive and have few side effects.