New Guidelines for High Blood Pressure: What You Need to Know

For millions of Americans struggling with slightly elevated blood pressure, a new set of guidelines released by the American Heart Association and American College of Cardiology this week should serve as a call to action. What was once considered “pre-hypertension” is now high blood pressure.

“These new guidelines eliminate the pre-hypertension stage,” says David Shipon, MD, FACC, FACP, Preventive/Sports Cardiologist and Director of Cardiac Rehabilitation at Jefferson Health. “If a patient’s blood pressure is greater than 130/80, they have stage 1 hypertension.”

Patients should note that the designation for “normal” blood pressure hasn’t changed, and is still any reading below 120/80.

Why Have the Guidelines Changed?

In short, the guidelines have changed to reflect the serious impact high blood pressure can have on your health. It helps both doctors and patients tackle the issue earlier.

“There is substantial evidence that people with hypertension, even on the lower end that was previously considered pre-hypertension, have a substantial risk for heart attacks and strokes,” says Dr. Shipon. “They can have up to two times the risk as someone with blood pressure in the normal range for these types of serious health problems.”

In fact, hypertension is the number one cause of stroke and one of the strongest risk factors for a cardiac event.  By raising the alarm about blood pressure sooner, doctors and patients can discuss lifestyle changes, such as diet and exercise, as well as medication.

What’s in a Number? Understanding Blood Pressure

When you get a blood pressure reading in the doctor’s office, you’ll hear two numbers. The top number of the reading is called you systolic pressure, which is the pressure in your arteries when your heart contracts to push blood around your body. The other number, called diastolic pressure, is the pressure in your arteries between heart beats.

These numbers matter because they provide your doctor with an idea of how much stress is being placed on arteries, heart, and other organs. When your blood pressure is too high, your risks increase. In addition to heart attacks and stroke, high blood pressure can also cause problems with your kidneys, your eye sight, dementia, and even sexual dysfunction.

It’s important to note that one high blood pressure reading is no reason to panic. Things in your life like stress, strenuous activity, and even the coffee you drank in the morning before your doctor’s visit can affect your blood pressure.

“One high blood pressure reading should put up a red warning flag,” says Dr. Shipon. “However, we would still advise at least two readings on two separate occasions to get the most accurate assessment.”

This is why the new guidelines recommend even more aggressive ambulatory blood pressure monitoring. Ambulatory blood pressure monitoring measures your blood pressure at intervals while you are walking around and performing normal daily activities. It uses a monitoring device hooked to your belt and connected to a cuff around your upper arm. This gives the doctor a fuller picture of your blood pressure and any potential problems with it.

If Your Blood Pressure Is High, What Should You Do?

“Poor diet and lack of exercise can account for up to 90 percent of hypertension,” says Dr. Shipon. “Improving your dietary choices, following a heart-healthy diet, and exercising regularly can help.”

The DASH diet, which Dr. Shipon recommends, can help lower blood pressure. It focuses on eating:

  • More fruits, vegetables, and low-fat dairy foods
  • Fewer foods loaded with cholesterol and saturated and trans fats
  • Whole grains, fish, poultry and nuts
  • Fewer sugary drinks, sweets, red meat and less sodium

Even if your numbers are currently in the normal range, it’s important to remain vigilant.

“Know your numbers and get your blood pressure checked at least once a year,” says Dr. Shipon. “Don’t let symptoms be your guide, since high blood pressure is typically silent until it causes a cardiovascular event.

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