In October 2017, about 70 million American adults (29%) had high blood pressure—that’s 1 in every 3 American adults at that time. That statistic just increased to nearly 50% of all Americans with the publication of new high blood pressure guidelines as of November 2017. With the announcement of these new guidelines, more than 30 million adults with a systolic blood pressure (the top number) of 130 to 139, or a diastolic blood pressure (the bottom number) of 80 to 89, got a new diagnosis of stage 1 hypertension. For people who fall into the stage 1 category, medication isn’t recommended unless you’ve already had a heart attack or a stroke, or you’re very likely to have one because you do or have things that raise your odds of having them, like smoking or diabetes. At this early stage of high blood pressure, people need to address lifestyle changes to try and lower blood pressure to more normal levels, versus adding a medication to their health routine.
Advice found in an article published on WebMD stated that, “People should not neglect the importance of what they can do to control their blood pressure,” says Steve Nissen, MD, chairman of the department of cardiovascular medicine at the Cleveland Clinic in Ohio. This article also mentioned that the most effective ways to lower blood pressure are to lose weight and to follow a diet that’s low in sodium and higher in potassium from fruits, vegetables, and whole grains called the DASH diet. “Obesity is very, very closely tied to increased blood pressure,” says Nissen. These new guidelines, at 130/80 mm Hg rather than 140/90, were developed by the American College of Cardiology and the American Heart Association. They account for complications that can occur at lower numbers and to allow for earlier intervention. The greatest impact of the new definition is expected among younger people. Additionally, the prevalence of high blood pressure is expected to triple among men under age 45 and double among women under 45.
Blood pressure categories in the new guideline are:
- Normal: Less than 120/80 mm Hg;
- Elevated: Systolic between 120-129 and diastolic less than 80;
- Stage 1: Systolic between 130-139 or diastolic between 80-89;
- Stage 2: Systolic at least 140 or diastolic at least 90 mm Hg;
- Hypertensive crisis: Systolic over 180 and/or diastolic over 120, with patients needing prompt changes in medication if there are no other indications of problems, or immediate hospitalization if there are signs of organ damage.
So women under 45 years of age, who were previously considered to have normal blood pressure should pay attention to these new guidelines and consult their doctors about beginning to make changes to their health before requiring medication. This includes limiting alcohol, quitting smoking, and regular exercise, which can each lower blood pressure by 4-5 points. If followed closely, the DASH diet, which stands for Dietary Approaches to Stop Hypertension, lowers blood pressure by about 11 points. This diet stresses limiting sodium, eating more fish, eggs, low-fat dairy, vegetables, whole grains, legumes, and fruit. In addition, the guidelines stress the importance of using proper technique to measure blood pressure; recommend use of home blood pressure monitoring using validated devices; and highlight the value of appropriate training of health care providers to reveal “white-coat hypertension.”
Making lifestyle changes now can help prevent the complications from high blood pressure, such as a heart attack or stroke later.