Friday, 24 November, 2017

New guidelines mean almost half of adults suffer from high blood pressure

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Melissa Porter | 14 November, 2017, 01:50

Americans with blood pressure of 130/80 or higher should be treated, down from the previous trigger of 140/90, according to new guidelines announced on Monday at the annual meeting of the American Heart Association in Anaheim, California.

Having high blood pressure is now defined as having a reading of 130/80 mm Hg and higher. The guidelines are being published by the American Heart Association (AHA) and the American College of Cardiology (ACC) for detection, prevention, management and treatment of high blood pressure. "White coat hypertension", which occurs when a person's blood pressure spikes while in the doctor's office, is a known phenomenon that can mar the test's accuracy. "We want to be straight with people - if you already have a doubling of risk, you need to know about it". The guidelines were last revised in 2003.

"Rather than one in three US adults having high blood pressure (32 percent) with the previous definition, the new guidelines will result in almost half of the USA adult population (46 percent) having high blood pressure, or hypertension", the groups said in a joint statement.

And for those considered high, they are urged to begin interventions like reducing salt intake and possibly adding medication to reduce blood pressure and in turn lower the risk for heart attack, stroke and heart failure. Previously, a blood pressure level of 140/90 was the baseline for being diagnosed with hypertension. "This now allows 14 percent of our population to understand that's a call to action".

High blood pressure is expected to triple among men under age 45 and double among women under 45, according to the new guidelines.

Dr. Shearer says people are usually diagnosed with high blood pressure in their 50's and 60's when arteries get stiffer but he says people as young as teens should get their blood pressure checked. Blood pressure is affected by a wide variety of factors including genetics, age, diet, exercise, stress and other diseases such as diabetes. "We didn't have that in previous guidelines". Bob Carey. He is vice chair of the 2017 Hypertension Practice Guidelines and dean emeritus of the University of Virginia School of Medicine. Home readings can also identify "masked hypertension", when pressure is normal in a medical setting but elevated at home, thus necessitating treatment with lifestyle and possibly medications. "This amounts to 4.2 million people, based on the US population".

Because the numbers are so important, experts are also issuing rules for measuring blood pressure.

Americans will be getting instructions on how to check their blood pressure every day to keep up with how they are doing.

"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.

In developing the guidelines, authors also analyzed more than 900 research studies, excluding those that did not meet strict research requirements. The studies were reviewed by 52 experts who submitted close to 1,000 questions, and approved by 11 partnering medical organizations.

“We need to send the message that yes, you are at increased risk and these are the things you should be doing, ” said Whelton, chair of global public health at Tulane University in New Orleans.

Normal: Less than 120 systolic pressure (the top number).