New Hypertension Guidelines

December 1, 2017

New Hypertension Guidelines were released recently to assist physicians and patients with more clarification to a new blood pressure classification system as well as updating the hypertension (HTN) treatment recommendations, with a clear emphasis on lifestyle approaches.

These changes will affect physician’s treatment to patients. For millions of patients who have been labeled as prehypertension, their diagnose will change to full on hypertension. Currently, approximately 75 million US adults (1 in 3 adults) have hypertension and only about half of them have their condition under control. This will increase physician’s role in assisting patients to achieve a healthier lifestyle (Metagenics Institute, 2017).

There are several lifestyle factors that contribute to high blood pressure and many can be modified. For example, overweight and obesity increases the pressure required to move the blood around the body. Patients and physicians should work together to create a weight loss plan that fits your lifestyle and provides the patient with the best results to reduce their hypertension. Smoking tobacco and excessive alcohol intake can cause hypertension as well by increasing the risk of developing cardiovascular disease. Both smoking and drinking have been known to cause dramatic affects on heart health and blood pressure levels. Smoking causes an immediate spike in blood pressure and can raise systolic blood pressure levels but as much as 4-millimeters of mercury; the nicotine inn tobacco sparks the nervous system to release chemicals that can constrict blood vessels and contribute to high blood pressure. Drinking is okay in moderation. Research shows that cutting back on alcohol consumption may be able to lower systolic blood pressure by levels of 3 millimeters of mercury.

Let’s compare the old levels of blood pressure to the new levels and discuss what the difference truly means to a patient. First let’s define systolic and diastolic to better understand what blood pressure readings mean. Systolic is the top number that refers to the amount of pressure in the arteries during the heart muscles contraction. Diastolic is the bottom number which refers to blood pressure when the heart muscle is between beats. In 2003, the Seventh Joint National Committee defined blood pressure cutoffs are:
• Stage I HTN: systolic BP 140-159 mmHg or diastolic BP 90-99 mm Hg
• Stage II HTN: systolic ≥ 160 mmHg or diastolic ≥ 100

The newest guideline from ACC/AHA keeps the normal BP as 2003 Seventh Joint National Committee, however, it eliminates the prehypertension category and recommends a new cutoff for high blood pressure, as stated below:
• Normal: systolic <120 mmHg and diastolic <80 mmHg • Elevated: systolic 120-129 mmHg and diastolic <80 mmHg • HTN Stage I: systolic 130-139 mmHg or diastolic 80-89 mmHg • HTN Stage II: systolic ≥140 mmHg or diastolic ≥90 mmHg • Hypertensive crisis: systolic >180 mmHg and/or diastolic >120 mmHg (guideline requires urgent medication changes or immediate hospitalization)

These new guidelines aren’t there just to diagnose patients but came with updated treatments to physicians to assist their patients in changing their lifestyle to a healthier one with setting goals in lowering their blood pressure to avoid medication unless necessary.

If hypertension, or high blood pressure, is left untreated this will cause a host of issues for the patient. This is the most common type of cardiovascular disease. When a patient has high blood pressure it requires the heart to work harder by forcing the blood to push against the walls of our arteries at an elevated level. High blood pressure is the leading cause of strokes and heart attacks. It will also increase the risk of heart and kidney failure and hardening of the arteries, a condition called atherosclerosis.

For help diagnosing high blood pressure, visit Quick Care Med Walk-In and Urgent Care’s in Citrus, Marion, or Alachua Counties. Our providers are knowledgeable in the new changes to the guidelines to assist patients in their diagnoses of high blood pressure.

Citations
Metagenics Institute. (2017, November 14). New Hypertension Guidelines Released by ACC/AHA. Retrieved November 22, 2017, from http://healthcareinstituteforclinicalnutrition.com/clinical-relevance/new-accaha-hypertension-definition-is-conservative/

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