Current blood pressure guidelines… know your numbers!

In 2017 the American Heart Association published new blood pressure guidelines based on recommendations from the American College of Cardiology and nine other health organizations. The new guidelines “lower” the range of numbers for the diagnosis of hypertension (high blood pressure) from 140/90 to 130/80 for adults 65 and younger. That means, for those with blood pressures over 130/80 they are now considered to be hypertensive. So why did the numbers change?

These new guidelines are a result of a 2017 Systolic Blood Pressure Intervention Trial (SPRINT), that studied more than 9,000 adults aged 50 and older who had systolic blood pressure (the top number) of 130 or higher; along with at least one risk factor for cardiovascular disease. The study’s focus was to determine if treating blood pressure to lower the systolic number to under 120 was beneficial compared to the previous target of 140 or less. The results concluded a significant benefit in lowering the risk of heart attacks, heart failure, and stoke by maintaining a systolic pressure under 120.

Additional benefits for the new guidelines

By lowering the blood pressure guidelines there have been other changes as well. Beginning with not recommending a different range of numbers for people younger or older than 65. In short, the new guidelines are no longer based on age.

The ranges also redefined the categories of hypertension and removed the “pre-hypertension”, category (120-139 over 80-89); instead, the current guide states people categorized as either “elevated pressure” (120-129 systolic and less than 80 diastolic) or as “Stage 1 hypertension” (130-139 systolic to 80-89 diastolic). Further, a pressure of 140/90 or higher is considered “Stage 2 hypertension” and anything above 180/120 is “hypertensive crisis”.

The important take away is that previously people considered in the normal range or pre-hypertensive are now considered to be at a higher risk than previously thought.

Learn to check your blood pressure at home

Knowing the benefits and risk factors associated with blood pressure, it is important that we all monitor our pressure often. Usually that is done at the doctor’s office, however, there are many options for purchasing blood pressure monitors you can use at home.

What type of monitor to use? Be sure to select a monitor that goes around your upper arm. Wrist and finger monitors are not precise. Try using an automatic monitor with a cuff that inflates itself and has a digital display you can read clearly. If possible, select a monitor that can wirelessly transfer the readings to your smart phone via an app which can store the date and create a graph of your readings.

Tips for checking blood pressure

  • systolic – is the top number of your reading and measures the force of the blood against your artery walls while your ventricles (lower two chambers of the heart) squeeze, pushing blood out to your body.
  • diastolic – the lower number measures how much pressure the blood exerts on the artery wall when the heart rests between beats
  • don’t drink a caffeinated beverage or smoke 30 minutes prior to testing
  • sit quietly for five minutes before testing
  • while testing, sit in a chair with your feet on the floor and your arm supported so you elbow is about heart level
  • if you use an automatic tester with an inflatable cuff, it should be completely over at least 80% of your upper arm and placed against bare skin (avoid placing over a shirt sleeve)
  • don’t talk during the test
  • leave the cuff in place, wait one minute and take a second reading. If the numbers are more than five points different repeat a third time and average them
  • keep a daily blood pressure record, including the time of day tested

As always, please consult your doctor on any and all health issues, including his or her recommendations on the best way to monitor your blood pressure.

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