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Five things you should know about the new blood pressure guidelines

Cardiologist Kimara March, MD, breaks down the new blood pressure guidelines that were recently issued by the American College of Cardiology and the American Heart Association.
Nearly half of all adults in the United States now have high blood pressure, according to new guidelines issued by the American College of Cardiology and the American Heart Association. We asked Cardiologist Kimara March, MD, to break down the new standards.

New blood pressure guidelines recently issued by the American College of Cardiology and the American Heart Association lowered the definition of hypertension, also known as high blood pressure. The move means nearly half of adults in the United States have hypertension.

Hypertension is a serious condition that—if left untreated—can lead to a variety of complications, including heart attack, stroke and heart failure.

To learn more about these new guidelines, what they mean for people and how patients can monitor their own blood pressure, we turned to University of Minnesota Health Cardiologist Kimara March, MD. March shared five things to know about the new blood pressure guidelines.

Learn more about University of Minnesota Health Heart Care.

The new guidelines lower the criteria for hypertension.

The new blood pressure guidelines lower the criteria for stage 1 hypertension to include systolic blood pressures ranging from 130-139 mm Hg and diastolic blood pressures between 80-89 mm Hg. Systolic blood pressure is the pressure in a person’s blood vessels when the heart beats. Diastolic blood pressure is the pressure in the blood vessels when a person’s heart is at rest between beats. The changes, March said, came after experts reviewed hundreds of studies showing that the risk of illness and death from hypertension increases substantially above 130 mm Hg.

“Instead of just simply calling it pre-hypertension, they’re now saying: Yes, you have hypertension. You have a problem and we need to do something about it,” she said.

Under the new guidelines, stage 1 hypertension is now known as stage 2 hypertension. Systolic pressures between 120-129 mm Hg were also reclassified to “elevated.” The new categories are as follows:

  • Normal: Less than 120/80 mm Hg
  • Elevated: Systolic pressure between 120-129 and diastolic pressure less than 80
  • Stage 1: Systolic pressure between 130-139 or diastolic pressure between 80-89
  • Stage 2: Systolic pressure at least 140 or diastolic pressure at least 90 mm Hg

Lifestyle changes are recommended for most with hypertension.

While the new guidelines mean nearly 50 percent of adults in the U.S. have hypertension, not everyone has to begin taking high blood pressure medications. For most people, it’s a matter of lifestyle changes rather than medication, March said.

“Your chance of dying from a heart attack or stroke is substantially increased at 130 mm Hg and you need to start making lifestyle changes to bring it down,” she said.

Lifestyle changes can include losing weight (which has a significant impact on high blood pressure), reducing salt or sodium intake, exercising, limiting alcohol and eating foods rich in potassium, March said.

Considering monitoring blood pressure at home.

To keep tabs on high blood pressure, people with hypertension or who are at risk for hypertension can purchase a blood pressure cuff for self-monitoring at home. March recommends that patients bring the new devices to their doctors’ offices to have them calibrated before attempting to use them at home. Home tests can help doctors get a clearer picture of a patient’s blood pressure, March said. Sometimes, people have higher blood pressure when visiting the doctor—a phenomenon known as “white coat hypertension.” Others may experience higher blood pressure only at home, which is known as “masked hypertension.”

“We just want to know where they are at throughout the day, so those at-home blood pressure readings are really important,” March said.

Pulmonary hypertension is high blood pressure that affects only the blood vessels in the heart and lungs. Learn more about our care for this condition.

Early action to address hypertension may save lives.

The new, broader guidelines can serve as a wake-up call for those experiencing higher-than-normal blood pressures. If a person has elevated or high blood pressure, it’s important to take action. If left untreated, high blood pressure can wreak havoc on the body by gradually damaging or narrowing of the arteries, or causing an aneurysm.

“We want to raise awareness. People need to make lifestyle changes early before they’re diagnosed with hypertension so they don’t experience lasting damage to the arterial walls,” March said.

For more information, speak with your primary care provider.

If you have questions about the new guidelines, you should consider speaking with a primary care provider, March said. Because primary care providers are often evaluating a wide range of medical issues, they may gloss over higher-than-normal blood pressures.

“If you have a history of heart attack or stroke, go to your doctor and make sure your systolic blood pressure is at least less than 130—and ideally less than 120,” March said. “If your blood pressure is high, ask your doctor: Why aren’t you treating my blood pressure more aggressively based on this information?”