Half of U.S. adults have high blood pressure under new guidelines

A patient getting blood pressure checked

The American Heart Association released a major update regarding new blood pressure guidelines and under the changes, more Americans are considered to have high blood pressure.

In the first update to US guidelines on blood pressure in 14 years, a writing committee changed the definition of high blood pressure from 140/90 millimeters of mercury or higher to 130/80 or higher.

Home blood pressure monitoring also will be emphasized to avoid "white-coat hypertension" - the tendency for some people to have higher blood pressure in a medical setting than they do in everyday life, the report said. Blood pressure levels should be based on an average of two to three readings on at least two different occasions, the authors said.

"In young healthy people with flexible blood vessels, elastic and compliant, the numbers tend to be low or normal", said Dr Mark Lampert, A NorthShore University Healthsystem Cardiologist. However, there will only be a small increase in the number of USA adults who will require antihypertensive medication, authors said.

The new guideline is created to help people take steps to control their blood pressure earlier, according to the authors.

The government agency did not help write or officially endorse the guidelines - a change from previous versions - but it did back key research, including the 2015 study showing the value of lower blood pressure targets. The Association now generally recommends that patients with Stage 1 hypertension only be prescribed medication in the event of a heart attack or stroke, and they're also recommending that pharmaceutical companies combine multiple blood pressure drugs.

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The change reclassifies 14 percent of United States adults, who were once deemed "high normal" and now have a more critical diagnosis. In addition to tightening the definition of high blood pressure, the new report does away with the old category of "pre-hypertension", which was defined as a top (systolic) reading of 120 to 139 or a bottom (diastolic) number between 80 and 89. The prevalence of high blood pressure is expected to triple among men under age 45 and double among women under 45. Prescriptions for blood pressure drugs are not expected to leap under the guidelines, experts said.

Additionally, Ferdinand said he hopes people will "be less comfortable with blood pressures that put them at risk, and will now seek attention and treatment when they might not have before".

Systolic pressure - or the force on arteries during a heartbeat - should not exceed 120. Bob Carey, vice-chair of the guidelines committee and professor of medicine at the University of Virginia Health System School of Medicine. The studies were reviewed by 52 experts who submitted close to 1,000 questions, and approved by 11 partnering medical organizations.

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.

Stage 1: Systolic between 130 and139. "There is an opportunity to reduce risk without necessarily imposing medications", said Richard Chazal, the immediate past president of the American College of Cardiology. The lower number is the diastolic reading, or the pressure level between the contractions when the heart is filling with blood.