URBANA, Ill. - In November of 2017, the American College of Cardiology and the American Heart Association released the first comprehensive guidelines for managing high blood pressure in adults since 2003. The update was created to identify and treat hypertension (high blood pressure) sooner. Research shows a very clear link between high blood pressure and cardiovascular disease, making you twice as likely to suffer a stroke or heart attack, explains University of Illinois Extension educator Marilyn Csernus.
Doctors previously diagnosed hypertension as blood pressure above 140 systolic (top number) or above 90 diastolic (bottom number). Now, Stage 1 hypertension is 130-139 mm Hg and 80-89 mm Hg. Stage 2 hypertension is greater than or equal to 140 mm Hg, or greater than or equal to 90 mm Hg.
The new guidelines classify normal blood pressure as less than 120/80 mm Hg. There is a new category of elevated blood pressure, without a diagnosis of hypertension. Elevated blood pressure is between 120-129 mm Hg and less than 80 mm Hg.
“All of these different numbers and categories can be confusing,” Csernus says. “One of the most important changes is that what used to be considered normal blood pressure is no longer normal.
“Because there are often no symptoms—yet it significantly increases the risk for heart disease and stroke—hypertension is known as a ‘silent killer.’ These updated guidelines mean more adults will now have hypertension, but not all will necessarily require medication. Lifestyle changes may be enough to bring blood pressure down to a normal range for some people.”
Positive changes in lifestyle behaviors have a cumulative effect on lowering blood pressure. Csernus says the most effective lifestyle interventions are weight loss and a healthy eating plan like the Dietary Approach to Stop Hypertension (DASH). The DASH plan is rich in fruits, vegetables, fat-free or low-fat milk and milk products, whole grains, fish, poultry, beans, seeds, and nuts. The DASH plan is lower in sodium and rich in other nutrients that lower blood pressure. Other positive interventions include regular physical activity and moderate alcohol intake.
“Accurate blood pressure readings are the first step in diagnosing hypertension. Caffeine, nicotine, and exercise can affect blood pressure and should be avoided within a half-hour of a blood pressure check. A correctly fitted and placed blood pressure cuff is necessary for an accurate reading,” she adds.
When checking blood pressure, the cuffed arm should be placed on a flat surface at heart level. Sit upright with feet flat on the floor and back straight. Do not talk during a blood pressure reading. Use the average of two blood pressure readings taken at least one minute apart, after sitting quietly for five minutes.
“If using a home blood pressure device, keep a log of the readings to share with your health care provider. Take your home device along to your appointment to make sure it is accurate,” Csernus says.
An elevated blood pressure reading should not be taken lightly. “Remember, each positive lifestyle change made can cumulatively reduce blood pressure. If lifestyle changes are not enough, medication will be needed to maintain normal blood pressure and prevent the risk of a heart attack or stroke. Individual recommendations and treatment for blood pressure should come from your health care provider,” she adds.