According to a latest aggressive hypertension treatment guidelines released by heart doctors 30 million Americans are gripped in the clasp of high blood pressure and need to do something about it.
Leading doctors and other experts, from the American College of Cardiology, the American Heart Association, and nine other groups, are moving the goal line for blood pressure control, i.e. 46 percent of U.S. adults — about 103 million — could now be diagnosed with hypertension. That’s up from 32 percent, or 72 million, under older guidelines.
Most of those added people will be asked to change their diets, exercise more and make other necessary lifestyle changes, instead of taking medication.
The guidelines also call on patients who are already in treatment to work toward lowering the goal – a reading of not more than 130/80, down from the old standard, 140/90.
Although it’s significant, the change is not as big as some experts thought after the study in 2015 depicted reaching even lower readings saved lives. The new goal will bang “an appropriate balance between efficacy… and safety,” for those who will be asked to take more prescribed drugs that can pose side effects such as dizziness and be falling, says Bob Carey, vice-chair of the guideline committee and a professor of medicine and dean emeritus at the University of Virginia Health System School of Medicine.
At present, it’s still not clear how widely or rapidly front-line doctors will embrace the changes, but if and when they do, here is what patients should expect:
- If your blood pressure is between 130/80 and 140/90, your doctor will tell you that you have “stage one” hypertension, suggesting you to lose weight, exercise, cut salt and eat lots of fruits, vegetables, and whole grains.
- If you have stage one hypertension along with some additional risk factors – such as a heart attack, previous stroke, diabetes or kidney disease – then your doctor will ask you to try medication, along with lifestyle changes.
- If your blood pressure is above 140/90, your doctor will recommend you make some lifestyle change and consume two kinds of blood-pressure lowering medications.
- Patients who are already taking medications might be put on higher doses or to some additional drugs to reach the new lower goal. However, those who are above the age of 65 will be asked to talk to their doctors about how aggressively they want to be treated.
The guidelines, presented at the heart association meeting and published in the Hypertension and the Journal of the American College of Cardiology, also suggest out exactly how health care providers and individuals at home should check blood pressure.
For example, doctors and nurses are asked to let their patients rest for five minutes first and then to average at least two readings on two visits. Patients are also asked to take regular readings at home, with the device checked out by their healthcare providers.
The reason why blood pressure matters so much is that as we age, it tends to rise and gradually damages our blood vessels, increasing the risks for heart attack, stroke, kidney damage and other health issues. By the time readings reaches to 130/80, risks have now already doubled, says guideline chair Paul Whelton, a professor of global public health at the Tulane University School of Public Health and Tropical Medicine.
“We want to be straight with people – if you already have a doubling of risk, you need to know about it,” says Whelton. “It doesn’t mean you need medication, but it’s a yellow light that you need to be lowering your blood pressure.”
The guidelines also “have the potential of improving the health of millions,” and it is supported by a solid science, told David Goff, director of cardiovascular sciences at the National Heart, Lung, and Blood Institute.
The government agency didn’t help while writing or officially endorsed the guidelines — the changes from the previous versions — however, it did back key research, including the 2015’s study showing the significance of lower blood pressure targets. The study also showed many people can attain lower targets, says Goff.
At present, only about half of Americans with hypertension under the previous guidelines have it under the control, says Whelton, the guideline chair. “I don’t underestimate the challenge of what we need to do.”