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New blood pressure guidelines: A year later, there’s still work to be done

Wednesday, November 21st, 2018 | by

A year ago, the definition of what counts as a healthy blood pressure changed. Men and women who used to be in the high end of the normal range—what was called “prehypertension”—were now considered hypertensive.

 

130/80 became the new high

Before November, 2017, 140/90 or higher was considered hypertensive. Now, a systolic blood pressure reading (the higher number) of 130mmHG and a diastolic measurement of 80mmHG (the lower number) are the baseline for high blood pressure.

Blood Pressure
Category
Systolic mmHg
(top number)
 
Diastolic mmHg
(bottom number)

Normal
Less than 120
and
Less than 80

Elevated
120 to 129
and
Less than 80

High blood pressure
Hypertension stage 1
130 to 139
or
80 to 89

High blood pressure
Hypertension stage 2
140 or higher
or
90 or higher

Hypertensive emergency
See your doctor right away
higher than 180
and/
or
Higher than 120

*ACC/AHA 2017 High Blood Pressure Clinical Practice Guideline

 

The new normal: <120 over <80

A blood pressure of less than 120mmHG for the systolic and less than 80mmHG for the diastolic is considered normal. The changing guidelines were an eye-opener for many individuals and families. Others are unaware of how their picture of health changed in the past year.

 

What blood pressure changes meant for many Americans

Last November almost half of U.S. adults were now considered hypertensive. The under-45 age group was deeply affected, tripling the previous numbers for men and doubling them for women.
While the changes may seem frightening, they’re more of a wake-up call than a case of bad news. With awareness, the new numbers help capture more of the impact of high blood pressure for more people.

 

Why the blood pressure numbers changed

The American College of Cardiology (ACC) and the American Heart Association (AHA) changed blood pressure guidelines for at least two reasons:

  1. To account for complications that can happen at lower numbers
  2. To target earlier intervention

The changes shift the way we think about what’s now considered an elevated blood pressure, 120-129mmHG and less than 80mmHG. Elevated blood pressure has the possibility of worsening into full-blown hypertension. It can also be dangerous for pregnant women and their babies.

 

Lower numbers can cause pregnancy risks

While elevated (vs. high) blood pressure may not show any symptoms, it can present risks to baby including low birth rate and even miscarriage. This type of high or elevated blood pressure is different than preeclampsia, a condition that can develop 20 weeks into pregnancy.

Home blood-pressure monitoring has been shown as a safe way for pregnant women to keep an eye on their blood pressure between doctor visits.

 

Blood pressure causes

Some causes of high blood pressure are better known to most Americans. These include alcohol use, high sodium intake, inactivity, obesity, smoking, and high stress levels. Other causes of high blood pressure may be less well known or less obvious:

  • sleep apnea
  • adrenal and thyroid disorders
  • atherosclerosis
  • genetics
  • kidney disease
  • aging

 

Hypertension isn’t always the silent killer

Hypertension is often called the “silent killer” because of its lack of obvious symptoms. But once it reaches about 180 over 110mmHg, it becomes a hypertensive crisis and can show signs like:

  • blurred or double vision
  • breathlessness
  • dizziness
  • headache
  • nausea or vomiting
  • nosebleeds
  • heart palpitations

 

High blood pressure symptoms in children

Premature birth, or kidney, heart and lung problems can cause high blood pressure in newborns and young babies. They may experience failure to thrive, seizure, irritability, lethargy or respiratory distress.
Older children can have symptoms like headache, fatigue, blurred vision, nosebleeds, and Bell’s palsy or the inability to control facial muscles on one side.

 

Treatment and prevention of high blood pressure

Along with home monitoring and prescribed medications, high blood pressure can be treated with lifestyle changes. Maintaining a healthy weight, getting exercise, practicing good nutrition, reducing sodium, limiting alcohol and quitting smoking can all help keep blood pressure in the normal range.

Going for zero heart attacks and strokes

About half of people with untreated high blood pressure die of heart disease, and another third of them die of stroke. For Omron Healthcare, Going for Zero™ means coming together to share technology, education and personal commitments—moving quickly toward a world without heart attacks and strokes.