My BP is the same, so why is it suddenly too high?
When you meet with your doctor for your annual checkup this year, you may find that you suddenly have high blood pressure – even if your readings haven’t changed since the last time it was taken.
The first comprehensive new blood pressure guidelines in 14 years define 130/80 as high blood pressure rather than the previous standard, 140/90. According to the American Heart Association and American College of Cardiology, this shift means that the number of American adults with high blood pressure has suddenly risen from 72 million to 103 million.
The new normal blood pressure is anything less than 120/80.
“Now, instead of one out of every three patients having high blood pressure, we can expect about 46 percent—nearly half—to be diagnosed with high blood pressure,” said Peter Crosson, MD, an internal medicine physician at Emerald Physicians. “But there should only be a small increase in the number of people who need medication.”
Young people whose readings are between 120-129/80 are probably going to be affected most, and they can typically bring their blood pressure down by making lifestyle changes instead of being medicated, according to Dr. Crosson.
“The new guidelines are eye-opening. Research shows that readings of 130/80 double your risk of having a cardiovascular complication or event, so we have to change our way of thinking as well as our approach to managing blood pressure. Because 130/80 had been considered a normal, well-controlled blood pressure for some time, doctors will be educating and counseling patients more,” he said.
High blood pressure, or hypertension, is the number one cause of death in the world, and the second leading cause of death in the U.S.
“It’s important to understand that the new guidelines are designed to help us address a potentially deadly condition much earlier,” said Dr. Crosson.
The guidelines are not arbitrary and are based on a great deal of research, he added.
“The guidelines were written by a panel of 21 scientists and health experts who reviewed more than 900 published studies.”
What You Need To Know
According to the American Heart Association, the new blood pressure categories are:
- Normal: Less than 120/80 mmHg;
- Elevated: Top number (systolic) between 120-129 and bottom number (diastolic) less than 80;
- Stage 1: Systolic between 130-139 or diastolic between 80-89;
- Stage 2: Systolic at least 140 or diastolic at least 90 mmHg;
- Hypertensive crisis: Top number over 180 and/or bottom number over 120, with patients needing prompt changes in medication if there are no other indications of problems, or immediate hospitalization if there are signs of organ damage.
“Blood pressure changes from minute to minute, so you can have two different readings back-to-back,” said Dr. Crosson. “Your blood pressure levels should be based on an average of two or three readings taken on different days.”
The new guidelines also encourage patients to monitor their blood pressures at home, which Dr. Crosson has endorsed for some time.
“Being able to monitor your own blood pressure at home helps you work in collaboration with your physician. I encourage my patients to bring their blood pressure cuffs to the office; we’ll make sure they’re accurate, and we can read the last few entries to track their readings,” he said.
At-home blood pressure readings can help with ‘white coat hypertension,’ or a spike in blood pressure when the patient is at a medical appointment, Dr. Crosson said.
“For instance, I have one patient who is always 170/90 in the office. At home, she’s 110/70, which is well within the new normal range.”
Some patients are bringing in their readings to appointments, which were taken by a special app that allows your blood pressure cuff to send the information to your smart phone, he said.
When the new high blood pressure guidelines were announced in November 2017, there was a surge of press. Now, doctors and patients are dealing with the day-to-day implementation, which Dr. Crosson said begins with education.
“These changes are going to take time to implement, and education is a big part of that. Patients and doctors are learning together, and I believe these new evidence-based guidelines can help us lower cardiovascular risk,” he said.
As of 5/1/2019, Emerald Physicians joined Medical Affiliates of Cape Cod (MACC), a division of primary and specialty care physicians from Cape Cod Healthcare.