AHA Announces Changes in Blood Pressure Standards

Reading Eagle, Pa.

Nov. 21—Nearly half of American adults are living with high blood pressure, according to new guidelines released last week by the American Heart Association and a panel of leading heart health experts.

The heart association announced the first change to the blood pressure standards in 14 years, tightening the guidelines to include millions more American adults.

People with a blood pressure reading of 130 over 80 will now be considered to have high blood pressure, down from the previous standard of 140 over 90.

In Berks County, area doctors applauded the move, saying they are always fighting to convince patients that living with high blood pressure is dangerous.

"We know a lot of people who were walking around under the old criteria who didn't know they had high blood pressure," said Dr. Mary Kelleher, chief medical officer of the Berks Community Health Center. "There was a huge segment of the population we knew weren't getting taken care of because they didn't know."

Before the change, about 32 percent of American adults fit the definition for hypertension. After, that number will shoot up to 46 percent, the heart association estimates.

Doctors have always taken an interest in blood pressure readings, particularly as they creep closer to 130 over 80, said Dr.Eric Elgin, chief of the cardiology section at Reading Hospital.

The risk at that level has always been a concern, he said.

"A high blood pressure doubles your cardiovascular risk," Elgin said. "It's a significant risk factor for strokes, heart attacks, blindness and kidney failure, blockages of arteries in the legs. It's a significant risk factor that contributes to the development of a lot of medical conditions that we'd like to avoid."

The new recommendations were published in the American Heart Association journal, Hypertension and the Journal of the American College of Cardiology.

The new guidelines will move more younger people into the hypertensive category. The prevalence of high blood pressure is expected to triple among men under age 45, and double among women under 45, according to the report.

Under the new guidelines, patients with a reading at 140 over 90 will be considered to have stage 2 hypertension. Previously, stage 2 began at 160 and 100.

The systolic pressure is the higher number and indicates the amount of pressure blood exerts against the artery walls when the heart beats. The lower number, the diastolic blood pressure, indicates how much pressure your blood is exerting against your artery walls while the heart is resting between beats.

The heart association said the new guidelines won't mean a dramatic increase in people taking high blood pressure medication. Officials estimate about one in five in the newly classified hypertensive group will need to start on blood pressure medications.

Instead, that group will begin talking with their doctors about high blood pressure much earlier.

Elgin said lifestyle changes, such as improving nutrition and daily exercise, are the first line of treatment to improve blood pressure numbers. After that, medicine comes into play.

"Just take a brisk walk every day," Elgin said. "We brush our teeth because we don't want cavities. We should take a brisk walk every day because we don't want heart attacks."

The new blood pressure standards made sense to Dr. Andrew Waxler, a cardiologist with Berks Cardiologists Ltd., Wyomissing.

He said cardiologists would prefer to avoid treating patients with strokes and heart attacks, but there's a lot of cardiovascular disease to treat locally and across the country.

"Patients really are resistant to being diagnosed with high blood pressure," said Waxler, who is also the incoming president-elect of the Pennsylvania chapter of the American College of Cardiology. "I still remember arguing with my grandmother that she didn't have high blood pressure. The reason they are resistant is because it has no symptoms."

Kelleher said moving those blood pressure numbers in the right direction is a hard task, but doctors and their patients have to try.

"This is showing we need to get to patients much earlier to prevent a poor outcome from occurring," she said.