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Do You Actually Have a Blood Pressure Problem?
First, let's understand do you actually have a problem. We're very quick to put someone on a medication. Drug companies would like blood pressure to be treated as low as possible so it benefits you to understand the risks and when intervention is actually needed. One bad blood pressure reading on one specific day is a very faulty way to understand the issue. Here are the new recommendations as of 2017 by the American College of Cardiology and the American Heart Association.
The new guidelines lower the definition of high blood pressure to account for complications that can occur at lower numbers and to allow for earlier intervention. The new definition will result in nearly half of the U.S. adult population (46 percent) having high blood pressure, with the greatest impact expected among younger people. Additionally, the prevalence of high blood pressure is expected to triple among men under age 45, and double among women under 45, the guideline authors note. However, only a small increase is expected in the number of adults requiring antihypertensive medication.
Blood pressure categories in the new guideline are:
Normal: Less than 120/80 mm Hg;
Elevated: Systolic between 120-129 and diastolic less than 80;
Stage 1: Systolic between 130-139 or diastolic between 80-89;
Stage 2: Systolic at least 140 or diastolic at least 90 mm Hg;
Hypertensive crisis: Systolic over 180 and/or diastolic over 120, with patients needing prompt changes in medication if there are no other indications of problems, or immediate hospitalization if there are signs of organ damage.
The guidelines eliminate the category of prehypertension, categorizing patients as having either Elevated (120-129 and less than 80) or Stage I hypertension (130-139 or 80-89). While previous guidelines classified 140/90 mm Hg as Stage 1 hypertension, this level is classified as Stage 2 hypertension under the new guidelines. In addition, the guidelines stress the importance of using proper technique to measure blood pressure; recommend the use of home blood pressure monitoring using validated devices, and highlight the value of appropriate training of health care providers to reveal "white-coat hypertension."
Medication, however, is NOT recommended for those in elevated or Stage 1 hypertension. As long as you have not had a previous heart attack taking meds for blood pressure below 140/90 is not warranted. Since it is now labeled "Hypertension" where previously it was pre-hypertension, drugs CAN now be subscribed to an additional 30 million Americans. With that new recommendation, 32% of people having hypertension grew to 46% overnight. Drug companies want these numbers to get tighter and tighter as they just gained 30 million new customers overnight!
There is strong evidence to support that that a new “normal” for someone over 60 is actually 150 over 90. That means, if you're over the age of 60, you can get away with your blood pressure being a little bit higher. I constantly run into patients 60 and older who are being treated for hypertension, and who did not know that those studies existed.
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