Thursday, 23 November, 2017

Redefined blood pressure guidelines means yours could be too high

Garlic high blood pressure GETTY Images Garlic supplements could cause'significant reductions in blood pressure
Marlene Weaver | 14 November, 2017, 03:24

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 by the American Heart Association and the American College of Cardiology.

Under the older, higher target, 32% of adults in the US had hypertension.

High blood pressure accounts for the second-largest number of preventable heart disease and stroke deaths in the United States, second only to smoking.

"I have no doubt there will be controversy". A healthier diet and more exercise, unsurprisingly, are the primary recommendations for those who fall into the new category of stage 1 hypertension, previously called "pre-hypertension" or "high-normal blood pressure", said Paul Whelton, chair of global public health at the Tulane University School of Public Health and lead author of the guidelines.

Currently, only half of Americans with high blood pressure have it under control. 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. Canada and Australia lowered their cutoff to that; Europe is still at 140 but is due to revise its guidance next year. The prevalence of high blood pressure will likely triple among men younger than 45, and double among women younger than 45. "We have to empower them with the tools to make a difference".

"The evidence with this is so solid, so convincing, that it's hard to argue with the targets", said Dr. Jackson Wright, a guidelines panel member from University Hospitals Cleveland Medical Center.

Dr. Larry Gordon from Aspirus said the association most likely made the changes to be proactive and lower the risk of people being diagnosed with more serious illnesses later on.

But the Cleveland Clinic's Dr. Steven Nissen said he's anxious.

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

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 decision also should consider the overall risk of having a heart problem or stroke in the next 10 years, including factors such as age, gender and cholesterol, using a simple formula to estimate those odds.

The guidelines warn about some popular approaches, though.

If the top number is between 120-129, pressure is considered elevated.

The change means nearly half of the nation's adults, or 103 million people, are technically classified as having hypertension, up from one-third.

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.

The guidelines don't pick a method, but recommend measuring pressure in the upper arm; devices that work on fingers or are worn on wrists "aren't ready for prime time", Whelton said. With the new guidelines, 46% of Americans have high blood pressure.

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