What do new blood pressure guidelines mean?

High blood pressure is the silent killer, and according to new guidelines, nearly half of all Americans have it.

In November, the American Heart Association and the American College of Cardiology issued new guidelines that change how high blood pressure, or hypertension, is diagnosed. Previously, it wasn’t until an adult’s blood pressure reached 140 mmHg or higher systolic (the top, or first, number) or 90 mmHg diastolic (the bottom, or second, number) or higher that high blood pressure was diagnosed. According to the new parameters, high blood pressure should be treated at 130/80 rather than 140/90, as that is the point when our risk for heart attack, stroke, and other consequences for hypertension almost doubles.

BLOOD PRESSURE CHART: What the numbers mean

Why does blood pressure matter?

We tend not to think about our blood pressure — it’s a normal function of our heart working regularly. However, when blood pressure stays high over an extended period it means the heart is working harder than it should. Since hypertension usually doesn’t have symptoms, we don’t know what is happening unless we measure it. Accurately measuring blood pressure provides a glimpse into what’s happening inside our bodies without needing expensive diagnostic tests.

Unchecked, high blood pressure can lead to a myriad of serious health problems, such as heart attacks, strokes, and other forms of heart disease and kidney disease. It is extremely dangerous during pregnancy because it contributes to devastating and even deadly problems for moms and babies. Other impacts of hypertension include vision problems and sexual dysfunction.

Do you need to worry about blood pressure getting too low?

Blood pressure guidelines show the lower the blood pressure numbers the better. As long as no symptoms of trouble are present there is no one number that doctors consider being too low. The guidelines call for an individualized, risk-based approach to managing hypertension, as well as a personal consultation with a health care provider. While the new guidelines mean we are more aggressive about blood pressure control, lifestyle changes are always a part of the treatment plan. A treatment plan is agreed to by patient and provider, and includes ongoing communication to see how the patient is feeling and how their medications are working.

Who will benefit from this change?

In short, everyone. The motivation behind the change was to make people healthier. With more sensitive guidelines, we are able to get in control of our blood pressure sooner and improve heart health before reaching levels that could cause more serious health problems. For some, the changing guidelines may result in antihypertensive (blood pressure lowering) medication, along with lifestyle management, but that will not be the case for everyone.

What is Department of Health doing to address high blood pressure?

There are three main activities Department of Health engages in to address high blood pressure.

First, we collect and analyze statewide data using telephone surveys, hospital information, and death certificates, so we are able to know which groups of people are experiencing hypertension and the impacts of uncontrolled high blood pressure. This includes looking at geography, age, racial/ethnic status, education levels, and other demographic information. When the data is compiled, we make it available on the DOH web site. We estimate that in 2015, nearly 14,000 deaths and 71,000 hospitalizations were due to heart disease and stroke.

Second, we train community health workers through a curriculum that enhances their ability to serve as health influencers in their community. For example, DOH provides blood pressure training that concentrates on improving the skills and knowledge about measuring blood pressure accurately.

Lastly, we conduct statewide outreach to health care organizations. We make and distribute a suite of materials available to encourage accurate and consistent blood pressure self-management in English, Spanish, Russian, Chinese and Vietnamese. We also work closely with Washington Information Network 211 so people can call or search online for places to get their blood pressure checked nearby.

Ready to take action?

High blood pressure can be prevented and managed by following these recommendations:

  • Stay active and move more.
  • Eat better — Limit sodium, eat more fruits and vegetables, and encourage healthy food environments in schools, institutions, and worksites.
  • Go tobacco free.
  • See your health care provider regularly, and manage other health conditions such as diabetes and high cholesterol.
  • Limit alcohol to 1 drink per day for women and 2 drinks per day for men; or better yet, abstain completely.
  • Know your family health history, and discuss your risk of heart disease with your health care provider.
  • Get your blood pressure checked. If you don’t have a health care provider you can call 211 or visit the Washington Information Network 211 website to find a location near you where you can check your blood pressure.
  • Support your children to be at a healthy weight.

Celebrate Heart Month

February is American Heart Month. Join DOH in raising awareness around heart disease and stroke this month. Remember, the best way to know if you have high blood pressure is to get measured. Know your numbers, and make changes that matter.

About the author: Sara Eve Sarliker is a heart disease and stroke prevention specialist for Washington State Department of Health.