The American Heart Association and the American College of Cardiology recently changed the guidelines for what is considered high blood pressure. Under new guidelines released in November 2017, the threshold for hypertension is now 130/80, down from the previous 140/90.
The new guidelines are based on increasing evidence that even mildly elevated blood pressure can have serious health consequences. Lowering blood pressure even further than what we used to consider normal greatly reduces the risks of future heart attacks, strokes, kidney failure and other life-threatening problems.
This change means that millions more people (almost half of all adults in the United States) will be diagnosed with high blood pressure, and that others are closer to it than they thought. That might sound alarming, but it points out an opportunity for all of us to take better control of this vital part of our health.
New blood pressure guidelines
| Normal | Below 120/80 | Keep up the good work |
| Elevated | 120/80-129/80 | Keep an eye on it |
| High — Stage 1 | 130/80-139/89 | Make changes or start meds |
| High — Stage 2 | 140/90 or higher | Medication recommended |
| Hypertensive Crisis | 180/120 | Consult doctor immediately |
Learn more at heart.org.
Where to begin? First, check your numbers
If you haven’t checked your blood pressure in a while, this is your wakeup call. All adults should have their blood pressure checked at least once a year. If it looks high in the doctor’s office, the guidelines recommend getting it checked again. Several high measurements or a trend upward means it’s time to take action.
The sweet spot for healthy blood pressure is still below 120/80. If you’re above that, making lifestyle changes to lower your numbers will do you a lot of good.
If you’re above 130/80 and your risk of having a heart attack in the next 10 years is 10 percent or more, medication might be advised in addition to lifestyle changes. Advancing age, smoking, diabetes and high cholesterol all could put you in that 10 percent risk range. To find out where you stand, use the risk calculator.
If your blood pressure is 140/90 or higher, the guidelines recommend starting medication regardless of your risk status.
Make healthy changes
The lifestyle changes known to lower blood pressure are great for your health in general — we all should be making these changes:
Exercise. Getting 90 minutes of aerobic exercise weekly can shave 5 to 8 points off your blood pressure; 90 minutes of weight training can cut 4 to 5 points.
Go low salt. Eating less salt can lower your blood pressure by as much as 11 points. Read nutrition labels and avoid foods that are high in sodium.
Eat better. Center your diet on fresh vegetables, fruits, whole grains, low-fat meats and low-fat dairy foods.
Drop a few pounds. If you’re carrying extra weight, losing just a little can make a big difference — about one point for every 2.2 pounds lost (up to five points).
Relax. Reducing stress also reduces blood pressure. Exercise (see above), stretching, yoga, mindfulness and getting out in nature are great stress relievers.
Get better sleep. Sleep apnea is a known cause of hypertension. If your sleep doesn’t feel restful, if you have increased daytime sleepiness or if you’re told that your breathing pauses during sleep, talk to your doctor about a sleep test.
Start medication if recommended. Lifestyle changes can help some people avoid the need for medication — but not everyone. If your doctor recommends meds, ask about the different types and which ones may be best for you. Keep in mind that most drugs for treating blood pressure have been around for many years, are very safe, have minimal side effects and are available in generic forms that cost just pennies a day.
Elevated blood pressure is not something to be taken lightly. Check your numbers and start a conversation with your primary care physician about what you can do to stay as healthy as possible, for as long as possible.
Dr. Sage, a primary care physician, sees patients at our Downtown location.
