YOUR BLOOD PRESSURE: WHERE DO YOU PLACE IN THE NEW GUIDELINES
If you didn’t previously have high blood pressure, there’s a chance you do now. That’s my case—suddenly my blood pressure isn’t “normal” any longer. Six months ago the American College of Cardiology and the American Heart Association released updated blood pressure guidelines. I thought I was doing pretty good with a blood pressure reading of 127/70, however this is now considered elevated.
Here’s info on what’s new from Monique Tello, MD, MPH in the November, 2017 Harvard Medical School article New high blood pressure guidelines: Think your blood pressure is fine? Think again…
A new definition of high blood pressure (hypertension)
(All numbers refer to mm Hg, or, millimeters of mercury.) The guidelines, in a nutshell, state that normal blood pressure is under 120/80, whereas before, normal was under 140/90.
Now, elevated blood pressure (without a diagnosis of hypertension) is systolic blood pressure (the top number) between 120 and 129. That used to be a vague category called “prehypertension.”
Stage 1 high blood pressure (a diagnosis of hypertension) is now between 130 and 139 systolic or between 80 and 89 diastolic (the bottom number).
Stage 2 high blood pressure is now over 140 systolic or 90 diastolic.
If you now have high blood pressure, you may not need meds… yet
The guidelines also outline very clearly when a diet-and-lifestyle approach is the recommended, first-line treatment, and when medications are simply just what you have to do. For the elevated blood pressure category, medications are actually not recommended; rather, a long list of evidence-based, non-drug interventions are. [Below] Simply changing what you eat can bring down systolic blood pressure by as much as 11 points, and each additional healthy habit you adopt can bring it down another four to five points.
For people with stage 1 hypertension who don’t have cardiovascular disease and are at low risk for developing it (less than 10% risk of an event within 10 years), lifestyle changes are still the way to go.
However, if a patient has any kind of cardiovascular disease and stage 1 hypertension (a blood pressure over 130 systolic or 80 diastolic), or no existing cardiovascular disease but a significant risk of developing it (over 10% risk within the next 10 years), then lifestyle changes plus medications are recommended. And, even if someone has less than a 10% risk, if their blood pressure is over 140 systolic or 90 diastolic, which is now stage 2 high blood pressure, they ought to be treated with medication as well.
Mountains of research over time have shown a very clear link between hypertension and cardiovascular disease. A 20-point higher systolic blood pressure or a 10-point higher diastolic blood pressure is associated with double your risk of death from a heart attack, stroke, or other cardiovascular complication. What many people don’t realize is that those who survive these events find their lives permanently altered by disability and medical complications.
Health Threats From High Blood Pressure (Hypertension)
Healthy arteries are flexible, strong and elastic. Their inner lining is smooth so that blood flows freely, supplying vital organs and tissues with nutrients and oxygen.
Hypertension gradually increases the pressure of blood flowing through your arteries. Here are excerpts from an article in heart.org, Health Threats From High Blood Pressure:
High blood pressure (HBP or hypertension) puts your health and quality of life in danger
Left uncontrolled or undetected, high blood pressure can lead to:
- Heart Attack— High blood pressure damages arteries that can become blocked and prevent blood from flowing to tissues in the heart muscle.
- Stroke— Hypertension can cause blood vessels in the brain to burst or clog more easily.
- Heart Failure— The increased workload from high blood pressure can cause the heart to enlarge and fail to supply blood to the body.
- Kidney Disease or Failure— Hypertension can damage the arteries around the kidneys and interfere with their ability to effectively filter blood.
- Vision Loss— High blood pressure can strain or damage blood vessels in the eyes.
- Sexual Dysfunction — This can be erectile dysfunction in men or lower libido in women.
- Angina— Over time, hypertension can lead to heart disease or microvascular disease. Angina, or chest pain, is a common symptom.
- Peripheral Artery Disease (PAD)— Artherosclerosis caused by high blood pressure can cause a narrowing of arteries in the legs, arms, stomach and head, causing pain or fatigue.
Controlling High Blood Pressure
Here are excerpts from the Mayo Clinic Article: 10 ways to control hypertension without medication.
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Lose extra pounds and watch your waistline
Blood pressure often increases as weight increases. Being overweight also can cause disrupted breathing while you sleep (sleep apnea), which further raises your blood pressure.
Weight loss is one of the most effective lifestyle changes for controlling blood pressure. Losing even a small amount of weight if you’re overweight or obese can help reduce your blood pressure. In general, you may reduce your blood pressure by about 1 millimeter of mercury (mm Hg) with each kilogram (about 2.2 pounds) of weight you lose.
Besides shedding pounds, you generally should also keep an eye on your waistline. Carrying too much weight around your waist can put you at greater risk of high blood pressure.
In general: Men are at risk if their waist measurement is greater than 40 inches. Women are at risk if their waist measurement is greater than 35 inches.
- Exercise regularly
Regular physical activity — such as 150 minutes a week, or about 30 minutes most days of the week — can lower your blood pressure by about 5 to 8 mm Hg if you have high blood pressure. It’s important to be consistent because if you stop exercising, your blood pressure can rise again.
- Eat a healthy diet
Eating a diet that is rich in whole grains, fruits, vegetables and low-fat dairy products and skimps on saturated fat and cholesterol can lower your blood pressure by up to 11 mm Hg if you have high blood pressure. This eating plan is known as the Dietary Approaches to Stop Hypertension (DASH) diet.
It isn’t easy to change your eating habits, but with these tips, you can adopt a healthy diet:
- Consider boosting potassium. Potassium can lessen the effects of sodium on blood pressure. The best source of potassium is food, such as fruits and vegetables, rather than supplements. Talk to your doctor about the potassium level that’s best for you.
- Be a smart shopper. Read food labels when you shop and stick to your healthy-eating plan when you’re dining out, too.
[In next week’s post I’ll list Foods that Help Lower Blood Pressure & Foods to Avoid with High Blood Pressure]
- Reduce sodium in your diet
- Limit the amount of alcohol you drink
- Quit smoking
- Cut back on caffeine
The role caffeine plays in blood pressure is still debated. Caffeine can raise blood pressure up to 10 mm Hg in people who rarely consume it. But people who drink coffee regularly may experience little or no effect on their blood pressure.
- Reduce your stress
- Monitor your blood pressure at home and see your doctor regularly
- Get support through family, friends or support groups
Knowledge is power. Hopefully, after reading this post (and next week’s post listing foods to help lower blood pressure and foods to avoid) and the actual online articles they’re drawn from, you’ll have a greater sense of what you can do to lower your blood pressure. Which will also lower your risk of a life-changing heart attack or stroke!