The American Heart Association (AHA) and the American College of Cardiology (ACC) have released a new clinical practice guideline on managing high blood pressure in adults, redefining hypertension as 130 mm Hg/80 mm Hg from the previous 140 mm Hg/90 mm Hg.
With this new definition of hypertension, approximately 14% more US adults are categorized as hypertensive (from 32% to 46%).
Paul Whelton, MD, writing committee chair, and his associates at AHA and ACC noted that one in five of the newly hypertensive patients will need medical treatment. The practice guideline focuses mainly on assisting healthcare professionals to help patients assess their risks and the preventive measures they can take against serious health issues.
The new guideline, published in the Journal of the American College of Cardiology and in Hypertension, divides systolic blood pressure (SBP) and diastolic blood pressure (DBP) into categories, giving patients a more specific definition of hypertension and the associated recommendations:
- Normal BP is defined as <120 mm Hg/<80 mm Hg. According to the guideline, this group of patients practices healthy living styles and should have yearly checks to monitor their BP.
- Elevated BP is defined as 120 to 129 mm Hg/<80 mm Hg. This group is advised to make healthy changes in lifestyle and to reassess their BP in 3 to 6 months.
- High BP is subcategorized into two stages:
- Stage 1: BP ranging from 130 to 139 mm Hg/80 to 89 mm Hg. Clinicians must assess 10-year heart disease and stroke risk. If the risk is <10%, the patient is highly encouraged to make immediate lifestyle changes, including medication with follow-ups until the BP is well-controlled.
- Stage 2: BP ≥140 mm Hg/≥90 mm Hg. Clinicians must stress lifestyle changes with 2 different classes of medications and monthly follow-ups until BP is well-controlled. Healthy life choices, according to the guideline, include quitting smoking, moderating alcohol consumption, increasing physical activity, and maintaining a healthy diet. Healthy life choices might also include medication and taking additional preventive risks for patients with higher, uncontrolled BP.
According to the authors, “Not only are CVD risk factors common among adults with hypertension, a higher percentage of adults with CVD risk factors have hypertension.”
- Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the prevention, detection, evaluation, and management of high blood pressure in adults, J Am Coll Cardiol. 13 Nov 2017. doi: 10.1016/j.jacc.2017.11.006
- Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the prevention, detection, evaluation, and management of high blood pressure in adults. Hypertension. 13 Nov 2017.