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14 November 2017, 02:11 | Lena Norman
A patient getting blood pressure checked
For the first time in more than a decade the American Heart association is getting tougher on high blood pressure issuing new comprehensive guildlines.
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.
The study authors recommend lifestyle changes, including exercise, diet modifications and weight loss, as the first step to reducing high blood pressure.
Harlan Krumholz (Yale University) said that the guideline represents "a major change in the recommendations, opting for more people being labeled with hypertension and recommended for treatment".
The guidelines were presented today at the Association's 2017 Scientific Sessions conference in Anaheim, the premier global cardiovascular science meeting for the exchange of the latest advances in cardiovascular science for researchers and clinicians. The guidelines were last revised in 2003.
The new guidelines from the AHA mean that almost half of all American adults - 46 percent - suffer from hypertension.
The guidelines also identified socioeconomic and psychosocial stress as risk factors for hypertension that should be considered in patient care. While some people may be concerned to learn they now have high blood pressure, Gianos says that the new guidelines are a sign that experts are learning and improving their advice to people in order to further lower their risk of dying from heart-related causes.
Regarding the move to a lower threshold for hypertension, Whelton pointed to the dangers of blood pressure levels between 130-139/80-89 mm Hg. "We want to be straight with people - if you already have a doubling of risk, you need to know about it". "This now allows 14 percent of our population to understand that's a call to action".
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The change is expected to have the biggest effect on men and women under the age of 45.
Many drugs are used to treat high blood pressure.
"It's actually not the most robust measurement", he said.
The guidelines stress the importance of home blood pressure monitoring using validated devices and appropriate training of healthcare providers to reveal "white-coat hypertension", which occurs when pressure is elevated in a medical setting but not in everyday life. "We didn't have that in previous guidelines".
Normal blood pressure still will be considered 120 over 80. The results favored the more aggressive treatment, but many hypertension experts were critical of the trial and said the 120-mm Hg goal should not be broadly adopted. "This amounts to 4.2 million people, based on the US population". "Masked hypertension is more sinister and very important to recognize because these people seem to have a similar risk as those with sustained high blood pressure". She is medical director of Heart Failure and Cardiac Transplantation at St. Vincent Heart Center of Indiana.
The 130-mm Hg systolic blood pressure goal in the new guideline suggests that the writing committee found a middle ground or compromise.
Blood pressure of 120/80 or above is considered elevated; 130/80 to 139/89 is now considered Stage 1 hypertension and anything 140/90 or above will be considered stage 2 hypertension.
Systolic pressure is the amount of pressure in your arteries during contraction of the heart muscle. Hypertension leads to cardiovascular disease, strokes, severe kidney disease and other maladies that kill millions of Americans every year.
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