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Understanding the New Blood Pressure Guidelines

Understanding the New Blood Pressure Guidelines
What's your blood pressure?

The leading cause of death worldwide is high blood pressure. It leads to problems like strokes, cardiovascular disease and kidney disease that kill millions every year. Unfortunately many people don't know they have high blood pressure because it doesn't always have symptoms.

Now the number of people who have high blood pressure has grown significantly higher. Here's why it changed and what it could mean for you.

Researchers at the National Heart, Lung and Blood Institute believed that the current “acceptable” levels of blood pressure were too high. They wanted to see what would happen if they helped people lower their blood pressure to 120 millimeters of mercury instead of the recommended 140.

In a study called SPRINT (for Systolic Blood Pressure Intervention Trial), 9361 people were tracked for 4-6 years. They were randomly divided into two groups. One had a target blood pressure of 120 millimeters of mercury and the other 140.

Within the first three years they found that the group with a target of 120 had lower rates of heart attacks, heart failure and stroke. The group with the lower target reduced their risk of death by nearly 25%. The results were so striking, they stopped the study early to share that information with the world.

Under the old guidelines, someone with blood pressure up to 129 was still considered normal. High normal was 130 to 139. The new guidelines list 121 to 129 as ELEVATED and 130 to 139 as STAGE 1 HYPERTENSION. 140 and up are considered serious, STAGE 2 HYPERTENSION.

 
Blood Pressure
Elevated
Stage 1 Hypertension
Stage 2 Hypertension
Systolic
< 120
121 - 129
130 - 139
140 +
Diastolic
< 80
80
80 - 89
90 +

The new numbers now mean that 46% of the adult population can now be classified with high blood pressure. For people over the age of 55 it's worse, with an estimated 70% of the population believed to have hypertension.

The reason for the change is to make people aware that their higher numbers put them at risk. It also gives everyone that new lower number of 120 as a goal. Working to achieve that lower target may save as many as 300,000 lives every year.

New Blood Pressure Guidelines

According to the doctors, here are the simple things you should do to protect yourself.

First, get a current blood pressure reading. If you don't know or it's been over a year since you've had your blood pressure checked, go find out. If your number is in any of the new warning ranges, schedule an appointment with a doctor or health care provider. Talk to them about any current health issues and medications, then ask about a plan to deal with your results.

Eat more plants and reduce the amount of meat you eat. People who primarily eat a plant-based diet, rarely have high blood pressure or the diseases it's linked to. Changes start happening as soon as a week after the diet has changed.

Limit how much sodium you eat. That's a more difficult thing to change, especially with the typical western diet. But high blood pressure, heart disease and strokes are virtually unheard of in people who keep their daily sodium intake to 1,500 mg or below,

Start exercising. Blood pressure tends to rise as body weight increases. Regular exercise can help take off pounds. Exercising and keeping your weight in the desirable range can lower blood pressure and improve overall health.

A Few Words of Caution...

In people over the age of 75, adding more medications to reduce high blood pressure can be risky. The side effects, interactions with other drugs or impact on your organs must be considered. The benefits may not be greater than the risk. You should talk with your doctor about the best approach for you. Consider the non-drug strategies mentioned earlier.

There's an increased risk of depression for people who learn they have a medical problem. It's known as the labeling effect. When people are officially labeled as sick, they may embrace the diagnosis and help make the worst predictions become their reality.

Fight back against labels. Don't identify as “someone with high blood pressure.” Instead see yourself as a regular exerciser, a person who gets a full nights sleep or someone who's eating more vegetables. Embrace the change instead of the diagnosis and enjoy the benefits of a healthier lifestyle.

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12/21/2019
Updated 10/31/2020

  • Make sure your blood pressure reading is accurate.

    1. Use the restroom before your test. If your bladder is full, it can raise your blood pressure because your nervous system thinks you're stressed.

    2. Relax for 15 minutes. When you engage in activity, any activity, your blood vessels constrict. When you sit for a few minutes, it gives your vessels time to return to normal size, reducing your blood pressure to a more accurate reading.

    3. Avoid finger cuff monitors. When compared to monitors used around the arm, finger cuff monitors weren't nearly as accurate, and they're prone to incorrect readings depending on finger positioning and body temperature.

    4. Don't put the blood pressure cuff on over clothing. Systolic pressure measurements can read up to 22 millimeters of mercury (mmHg) higher than when done on bare skin.

    5. Raise your arm to heart level. The National Heart, Lung, and Blood Institute base their measurements on people with arms held at heart level.

    6. The American Heart Association recommends taking a reading on BOTH arms. When arteries stiffen and harden, one side is often affected more than the other. If there's a difference of 10 mm Hg or higher in the systolic number, that could be a sign of cardiovascular problems.

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