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High blood pressure is redefined as 130, not 140

14 November 2017

The American Heart Association and American College of Cardiology lowered the threshold for high blood pressure on Monday.

While many patients need multiple drugs to get their blood pressure into a healthy range, most treatments are available as less-expensive generic pills.

The change is outlined in the American Heart Association 2017 Hypertension Practice Guidelines, an extensive report by experts without relevant ties to the pharmaceutical industry.

The lower threshold means an estimated 46 percent of US adults have hypertension, up from 32 percent using the previous definition.

While the new guidelines significantly increase the number of Americans with a diagnosis of hypertension, they do not suggest a proportionate increase in treating with medication. While some people may be concerned to learn they now have high blood pressure, Gianos says that the new guidelines are a sign that experts are learning and improving their advice to people in order to further lower their risk of dying from heart-related causes.

Systolic pressure - or the force on arteries during a heartbeat - should not exceed 120.

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And for those considered high, they are urged to begin interventions like reducing salt intake and possibly adding medication to reduce blood pressure and in turn lower the risk for heart attack, stroke and heart failure.

And because of that, both the American Heart and Stroke Association have scrapped the classification of pre-hypertension.

With the new guidelines, 46% of Americans have high blood pressure.

"You've already doubled your risk of cardiovascular complications compared to those with a normal level of blood pressure", he said.

"We will have a big jump in prevalence but you'll notice only a small increase in the number of people we believe will benefit from hypertensive drugs", Carey said. "It doesn't mean you need medication, but it's a yellow light that you need to be lowering your blood pressure, mainly with non-drug approaches". People with those readings will now be categorized as having Elevated, which is 120-129 and less than 80, or Stage I hypertension, which measures at 130-139 and 80-89.

The guidelines also call on patients already in treatment to work toward the lower goal - a reading of no more than 130/80, down from the old standard, 140/90.

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"It's very clear that lower is better", said Dr. Paul Whelton of Tulane University, who chaired the committee that wrote the guidelines.

The change is expected to triple the number of men under age 45 diagnosed with hypertension and double the number among women the same age.

"You're going to see a little bit more dizziness". That level is now considered Stage 2 hypertension under the new definition. Home readings can also identify "masked hypertension", when pressure is normal in a medical setting but elevated at home, thus necessitating treatment with lifestyle and possibly medications.

The new guideline is created to help people take steps to control their blood pressure earlier, according to the authors.

The update by the American College of Cardiology and the American Heart Association is based on a three-year review of nearly 1,000 studies.

In developing the guidelines, authors also analyzed more than 900 research studies, excluding those that did not meet strict research requirements.

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High blood pressure is redefined as 130, not 140