Monday, 20 November, 2017

New guidelines will mean millions more diagnosed with high blood pressure

A patient getting blood pressure checked A patient getting blood pressure checked
Ben Pena | 14 November, 2017, 01:21

"Nine out of every 10 times you see high blood pressure, it's because the diet or the nutrition isn't as good as it could be, it's because we're not as physically active as we could be and should be, and perhaps it's because we're consuming too much alcohol", lead guidelines author Paul K. Whelton, MB, MD, MSc, said in a video released by the American Heart Association (AHA).

The new guidelines eliminate the category of prehypertension, which was used for blood pressures with a top number (systolic) between 120-139 mm Hg or a bottom number (diastolic) between 80-89 mm Hg. Prescriptions for blood pressure drugs are not expected to leap under the guidelines, experts said. The guidelines were last revised in 2003.

"Rather than one in three USA adults having high blood pressure (32 percent) with the previous definition, the new guidelines will result in almost half of the US adult population (46 percent) having high blood pressure, or hypertension", the groups said in a joint statement.

"An important cornerstone of these new guidelines is a strong emphasis on lifestyle changes as the first line of therapy".

Carey said about 4.2 million more people would be diagnosed with high blood pressure under the new guidelines, but not all of them will be advised to take drugs - just 1.9 percent more, he said. "We want to be straight with people - if you already have a doubling of risk, you need to know about it". "This now allows 14 percent of our population to understand that's a call to action".

Ferdinand said he hopes the new guidelines will push clinicians to treat patients earlier on, which could reduce the number of cardiac-related deaths, specifically heart attack and stokes. The prevalence of high blood pressure is expected to triple among men under age 45 and double among women under 45.

Potentially deadly high blood pressure can be brought under control with a wide array of medications, many sold as relatively affordable generics.

The systolic reading refers to the pressure when the heart contracts and sends blood through the arteries.

"We're more specific about who should get treatment", Whelton said.

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A blood pressure tracker at the AHAs Check. Bob Carey. He is vice chair of the 2017 Hypertension Practice Guidelines and dean emeritus of the University of Virginia School of Medicine.

Previous guidelines classified 140/90 mm Hg as Stage 1 hypertension. "This amounts to 4.2 million people, based on the USA population".

According to Ferdinand, high blood pressure is the leading cause of heart conditions that lead to death and disability in America.

Joaquin E. Cigarroa, MD, the head of the division of cardiovascular medicine at Oregon Health and Science University, said 70 percent of the people now recognized at increased risk can be treated with nutrition and lifestyle changes alone.

Still, only about half of Americans with hypertension under the old guidelines have it under control, said Whelton, the guideline chair.

Under the new threshold for initiating treatment, patients assessed to be at higher risk of cardiovascular problems will also be started on medication, he said.

But patients in the 120 systolic blood pressure group had a higher rate of kidney injury or failure, as well as fainting.

And Stage 2 occurs at levels of 140 over 90. This is called diastolic pressure.

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