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New guidelines will mean millions more diagnosed with high blood pressure

14 November 2017

New guidelines issued by USA medical societies have expanded the definition of hypertension for the first time in 14 years, classifying 30 million more Americans as having high blood pressure.

The new guidelines reflect years of research, which have shown that people within the new range of blood pressure defined as hypertension have doubled their risk of cardiovascular problems in the future, such as heart attacks or strokes.

For those not needing immediate medical treatment, Ferdinand said doctors will encourage non-medical, lifestyle changes to bring their blood pressure down before it leads to more serious risks.

The old definition was 140 over 90.

"I have no doubt there will be controversy. So the earlier, the better", said Dr. Shearer.

Tighter blood pressure guidelines from USA heart organizations mean millions more people need to make lifestyle changes, or start taking medication, in order to avoid cardiovascular problems.

Practicing physicians and the public are "going to be a little bit shocked or taken aback by a diagnosis of Stage 1 hypertension with a blood pressure of 130/80, which historically has been considered a normal, well-controlled blood pressure", said Dr. William White, a professor in the cardiology center at the University of Connecticut School of Medicine. With the new guidelines, 46% of Americans have high blood pressure.

This comes after the American Heart Association redefined guidelines for the first time in almost a decade.

Tens of millions more Americans now have high blood pressure.

Previously, anyone who fell between 120-139 and 80-89 was deemed "prehypertensive" or "high normal". Now, everyone that old should be treated if the top number is over 130 unless they're too frail or have conditions that make it unwise. Diastolic pressure is measured when the heart relaxes between beats. The top number is known as the systolic rate, measuring the pressure on your blood vessels when the heart beats.

But the Cleveland Clinic's Dr. Steven Nissen said he's anxious.

Americans will be getting instructions on how to check their blood pressure every day to keep up with how they are doing. The decision also should consider the overall risk of having a heart problem or stroke in the next 10 years, including factors such as age, gender and cholesterol, using a simple formula to estimate those odds.

But the drugs have side effects and the new guidelines emphasize lifestyle changes including weight loss, diet and exercise as the first tool for combating hypertension. He said that until now there has been "a perspective that it's not that big of a risk, but that's just wrong". Many people are unaware that they have the condition because there are no symptoms.

The guidelines warn about some popular approaches, though.

Additionally, Ferdinand said he hopes people will "be less comfortable with blood pressures that put them at risk, and will now seek attention and treatment when they might not have before".

The government no longer writes heart guidelines, leaving it to medical groups. "We didn't have that in previous guidelines".

The guidelines were published in two journals - Hypertension and the Journal of the American College of Cardiology.

Dr. Shearer says people are usually diagnosed with high blood pressure in their 50's and 60's when arteries get stiffer but he says people as young as teens should get their blood pressure checked. Prescriptions for blood pressure drugs are not expected to leap under the guidelines, experts said. They recommend that those with hypertension use approved blood pressure monitors at home.

New guidelines will mean millions more diagnosed with high blood pressure