New guidelines will mean millions more diagnosed with high blood pressure

Don’t just get your BP taken make sure it’s taken the right way

But instead of recommending drug treatment right away, the organizations recommend that people with stage 1 hypertension try lifestyle changes first: exercising more, eating less salt, and eating more fruits, vegetables and whole grains. Under the previous guideline, 32 percent of US adults had high blood pressure.

Almost half of USA adults are classified as having high blood pressure under new national guidelines announced Monday, up from one-third of Americans by the old definition.

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.

They also recommend a new approach to accurately measure blood pressure. "We expect this guideline will cause our society and our physician community to really pay attention much more to lifestyle recommendations". Writing down these readings at home can help tell the difference between people with truly abnormal blood pressure and those with "white-coat syndrome" - with high blood pressure only under stress like at the doctor's office.

As for patients with elevated (120-129/ 80 mm Hg) blood pressure or Stage 1 (130-139/80-89 mm Hg) who are otherwise healthy, the guidelines say they should make healthy lifestyle changes.

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"There is high-quality evidence demonstrating that team-based care models, particularly with pharmacists and nurses, improves hypertension treatment and control", said Eric MacLaughlin, PharmD, FASHP, FCCP, BCPS, who coauthored the new guidelines as APhA's representative member of the Guideline Writing Committee.

The new guidelines incorporate data from the Systolic Blood Pressure Intervention Trial (SPRINT), which was a large, randomized controlled trial created to assess the impact of more aggressive versus standard blood pressure goals on hard cardiovascular outcomes. Diastolic pressure is measured when the heart relaxes between beats. Damage to the inside of arteries and other blood vessels can grow over time, and rates of hypertension increase with age. The prevalence of high blood pressure is expected to triple among men under age 45 and double among women under 45.

"This a major leap forward in bringing to our attention to the importance of the intensive treatment of elevated blood pressures, which is one of the most powerful, if not the most powerful, risk factor for heart attack and stroke", Ferdinand said. That rate was 25 percent less than the 319 events in the group of 4,683 patients that took less medicine, getting their blood pressure down to the low- to mid-130s. While that research only included people 50 and older and at high risk for heart problems, subsequent studies have shown this benefit appears to extend to younger people as well, said Chazal who is medical director at the Lee Memorial Health System in Fort Myers, Fla. The four main classes of drugs for blood pressure have generic versions and can be as cheap as a few dollars a month. It's known as a "silent killer" because often there are no symptoms.

"The fact is lower is better", Frieden said, "Even what we considered mild hypertension before is a deadly disease".


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