Confused by the New Blood Pressure Guidelines? Here’s What You Need to Know

What the new blood pressure guidelines mean for you

older man reading papers

Guidelines recently issued by the American Heart Association (AHA) and the American College of Cardiology (ACC) have lowered the definition of hypertension (high blood pressure) to a reading of 130/80 mm Hg or higher. “The new definition will result in nearly half of the U.S. adult population (46 percent) having high blood pressure,” according to a statement from the ACC. Under the previous guidelines, high blood pressure was defined as starting at 140/80 mm Hg, which meant that 1 in 3 American adults were considered to have the condition. The new criteria is the result of increasing evidence that maintaining blood pressure far lower than what had previously been considered “normal” greatly reduces the chances of a heart attack or stroke—as well as the overall risk of an early death.

What Do the Numbers Mean?
The new guidelines define five blood pressure categories and show ranges of both systolic (the top number) and diastolic (the bottom number) blood pressure. Systolic indicates how much pressure your blood exerts against your artery walls when the heart beats. Diastolic indicates how much pressure your blood exerts against your artery walls when the heart rests between beats.

The new guidelines have eliminated the category of prehypertension. The categories are now:

  • Normal: Systolic less than 120 anddiastolic less than 80 mm Hg.
  • Elevated: Systolic between 120 and 129 anddiastolic less than 80.
  • High Blood Pressure Stage 1: Systolic between 130 and 139 ordiastolic between 80 and 89.
  • High Blood Pressure Stage 2: Systolic at least 140 ordiastolic at least 90 mm Hg.
  • Hypertensive Crisis: Systolic over 180 and/or diastolic over 120. At these numbers, patients need prompt changes in medication if there are no other indications of problems, or immediate hospitalization if there are signs of organ damage.

Who Will Be Affected By the New Guidelines?
According to the study authors, the new guidelines will especially affect younger people. High blood pressure is now expected to triple among men under age 45 and double among women under 45.

How Does High Blood Pressure Affect My Health?
The higher your blood pressure, the harder your heart works to pump blood around the body. This puts extra strain on blood vessels and can cause your heart to enlarge. High blood pressure can also put you at risk of serious medical conditions, such as cardiovascular disease, kidney disease, diabetes, and stroke.

How Is High Blood Pressure Managed?
The new guidelines place a strong emphasis on adopting healthy lifestyle approaches to keep blood pressure in check. Lifestyle changes include getting regular exercise (activities that get your heart rate up), eating a heart-healthy diet, maintaining a healthy weight, moderating sodium (salt) intake, increasing potassium intake from diet, and moderating or eliminating alcohol consumption.

Eating to keep blood pressure under control means:

  • A diet that regularly includes fruits, vegetables, whole grains, low-fat dairy products, nuts and legumes, and fish.
  • If you eat poultry, remove the skin and fat.
  • Be aware of the types of fats you eat. Read food labels and limit saturated fats and trans fats.
  • Limit salt intake.
  • Limit red meat (cut off the fatty bits when you do indulge).
  • Reduce sugar intake in its various forms. Avoid soda and overly sweet juices.

Will I Be Prescribed Medications? 
It depends. According to Paul Whelton, professor of public health and medicine at Tulane University and chair of the Guideline Writing Committee, medication is generally only advised for people with Stage I hypertension if they’ve alreadyhad a cardiovascular event such as a heart attack or stroke, or if they are at a higher risk of a heart attack or stroke. Additionally, if someone has Stage 2 hypertension, they will likely be treated with medication.

If you have questions about the new guidelines, don’t hesitate to speak with your primary care provider.