AHA and ACC announce changes to Blood Pressure ranges!
With the announcement of the latest Blood Pressure Guidelines formulated by the American Heart Association (AHA) and the American College of Cardiology (ACC) more Americans than ever will now be considered to have High Blood Pressure. In fact, estimates of Americans who fall into the Hypertension category will now rise from around 32% to 46% which is a considerable increase and estimated to affect a further 4.2 million adults in the States.
This new, more aggressive approach to treating Hypertension means that the goalposts have been shifted and that anyone with a BP reading of 130/80 will now be deemed to have high blood pressure.
Blood Pressure Guidelines Chart – A Comparison of Old vs New
(AHA blood pressure guidelines chart)
The change above has essentially moved the goalposts up so that what was previously considered Prehypertension is split into two sections in the revised chart.
In other words the 120 – 139 Systolic (old) – Prehypertension has now been split into TWO new categories:
- 120-129 Systolic (new) – Elevated … AND
- 130 – 139 Systolic (new) – High Blood Pressure Stage 1
The lower range value – Diastolic measurement – has also changed so that what was previously placed under Prehypertension, i.e. 80-89 (Diastolic)
now falls into the category of High Blood Pressure Stage 1
Another way of putting this is that High Blood Pressure is now defined as 130/80 mm/Hg or higher, when before it was 140/90 mm/Hg
Just Another Money Spinner for Big Pharma?
Sceptics of this change might feel that this tightening of the High Blood Pressure Criteria could simply be a ploy by the Pharmaceutical Industry to sell more of its patented blood pressure lowering drugs to a wider group of Americans.
Whilst this will probably be a fortuitous by-product of these changes, the real thrust of the guideline changes is to intercept rising blood pressure in patients at an earlier stage and to introduce treatment sooner in order to minimize potential damage which unchecked high blood pressure has been shown to pose to the human body and human health generally.
The good news is that the treatment being suggested by these two Organizatins (AHA and ACC), and perhaps somewhat surprisingly, is not to automatically go down the pharmaceutical pathway.
As writing committee vice chair Robert Carey, MD (University of Virginia School of Medicine, Charlottesville) stated when announcing the new guidelines:
“We have lifestyle modification as the cornerstone of treatment for hypertension, and we expect that this guideline will cause our society and our physician community to really pay attention much more to lifestyle recommendations”
No Need to Panic!!
Even although these new guideline changes now place millions more adult Americans into the dreaded Hypertension bracket, there is absolutely no cause for panic.
Again as Dr. Carey commented:
“We will have a big jump in prevalence but you’ll notice only a small increase in the number of people we believe will benefit from hypertensive drugs,”
In fact according to his calculations there will only be around 1.9% more people needing to go on to hypertensive drug treatments.
The experts and Organizations behind the creation of these new guidelines are clear in their recommendations that they are first promoting a change in lifestyle which will help to address the issue for those people now being caught in the net of these tightened Hypertension Guidelines.
And what are these recommendations, exactly?
Well, in truth nothing that those of us already dealing with managing our BP naturally haven’t already come across before, I suspect.
- Increased Exercise
- Cutting back on Salt in the Diet, as well as consumption of Alcohol
- Adding a higher ration of Fruits, Vegetables and Whole Grains to your Diet
- Choosing to switch to a blood pressure/heart friendly diet, such as the DASH (Dietary Approaches to Stop Hypertension) Diet recommended by the American Heart Association.
In addition to the above mentioned recommendations, all of which I have addressed in previous blogs, I would add a couple more lifestyle changes which are most definitely beneficial to anyone who wants to keep their BP measurements under control.
- Find ways to deal with Stress in your Life – Meditation, yoga and various forms of relaxation and deep breathing are very useful for this.
- Never skimp on Sleep – Many studies show the importance of getting a good night’s sleep so the body can fully recuperate.
- Keep yourself Hydrated – with an emphasis on drinking filtered water from which chemicals, bacteria and other harmful toxins have been removed.
- Reduce the amount of Sugar in your Diet – This is a Biggie, as sugar (refined sugar especially) is not only a toxin, but it causes all sorts of inflammation within the body, as well as it has been shown to be as addictive as cocaine. Check out my blog on this for more details HERE
- Make Sure your Essential Minerals are Balanced – This is particularly important when it comes to Potassium and Magnesium, both of which play an integral part in keeping blood pressure properly regulated. Your body also needs Sodium for this, but not the refined type found in the common table salt variety.
Just Keep it in Perspective!
The fact is that, if you now fall into the category of Hypertension Stage 1, you WILL be able to find ways to reduce your BP readings naturally by adopting lifestyle changes.
I recommend looking at Diet, Exercise and Stress Management first
So when you do go to see your doctor and he brings the guideline changes up, which I am sure all physicians will be encouraged to do, make sure you are clear in your mind that these changes are not a mandate to be immediately placed on blood pressure medication. There are many other options which can and certainly should be tried first.
Your Doctor ought to be aware of this, but given that most practitioners first line of treatment is to prescribe pharmaceuticals, he or she may need to be gently reminded that it was not the intention of the Organizations, who spent 4 years studying this issue, to mandate the use of drugs as the only treatment option available.
As Dr. John Erwin from the A&M College of Medicine at Texas believes:
“Guidelines are just that. They are not meant to be inflexible algorithms. Shared decision-making and good clinical assessment of the individual’s frailty and risk must be factored in to these decisions.”
What about the Elderly?
Dr Erwin’s statement above is especially true of those people who are older, such as the elderly and the over 65 population. Studies released earlier in the year concluded that seniors actually benefitted from higher blood pressure. The research conducted at the University of California in Irvine¹ demonstrated that higher BP in the elderly tended to help counteract the onset of dementia by protecting the brain. It appears that the ageing body naturally increases blood pressure in order to ensure that the brain receives an adequate flow of blood, and is thus sufficiently oxygenated.
Admittedly this study was looking at people who were over 80 years of age, but it does suggest that a “one fit for all” solution is not necessarily the best way to go, especially for the over 65 age group – and those whose frailty does need to be considered. As Dr Steve Nissen, Chairman of Cardiology at the Cleveland Clinic stated in response to the new guidelines:
“There is a balance of benefits and harms from more aggressive blood pressure control, particularly in the elderly. I would have appreciated a little bit more guidance about assessing the fragility of patients and making a more careful determination, so that it’s really not one-size-fits-all.”
As with most disease processes, early detection is key, and I applaud the efforts made in these New Blood Pressure Guidelines to further the goal of early detection of hypertension, and the desire to promote lifestyle changes in order to prevent the harmful effects of letting it go untreated.
As Dr Paul Whelton of Tulane University, and one of the lead authors of the guidelines, summed it up.
“if you already have a doubling of risk, you need to know about it. It doesn’t mean you need medication, but it’s a yellow light that you need to be lowering your blood pressure.”
Research has shown that patients with blood pressure measurements between 130-139/80-89 mm Hg have twice the risk of cardiovascular problems, compared with those who have normal blood pressure readings.
That being said, I think the onus is on us individually to investigate the lifestyle modifications which will help us to either lower our blood pressure readings if they are already elevated. Or, if they are normal, to prevent them going into the elevated levels in the first place.
¹Maria Corrada, M.S., Sc.D., professor, neurology and epidemiology, University of California, Irvine published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association Jan 2017
If you would like to join the discussion about these New Guidelines please feel free to leave a comment below!