Blood Pressure of 130/80 Now Considered High, Say Stricter Guidelines

A new and stricter standard for determining the serious condition of hypertension, or high blood pressure, has been announced by the American Heart Association (AHA), the American College of Cardiology and other groups of healthcare professionals. Nearly half of Americans are now in the high blood pressure category based on the new guidelines.

The redefined reading of high blood pressure is now 130/80, down from 140/90. The stricter standard, the first major change in blood pressure guidelines in 14 years, means that 46 percent of U.S. adults, including an increasing number under the age of 45, now will be considered hypertensive. Under the previous guidelines, 32 percent of U.S. adults were considered hypertensive.

“If someone now has a blood pressure of over 130/80, it is no longer considered acceptable,” says Ian Del Conde, M.D., a cardiovascular specialist at Miami Cardiac & Vascular Institute. “We will now focus much more on getting patients to initiate lifestyle changes, including better diets, adding exercise and diminishing the consumption of alcohol. We want to prevent the high blood pressure from worsening.”

The new guidelines no longer include the category of “prehypertension,” which previously kicked in at systolic readings between 120 and 139 or a diastolic range between 80 and 89.

“This change will likely lead to earlier screening and management of cardiovascular risk factors in mid-life,” says Felipe De Los Rios, M.D., Medical Director, Stroke Program at Baptist Health Neuroscience Center. “This is what is needed to really decrease the risk of stroke and heart attack as we age. Hopefully, this change will also bring early management of the other risk factors, such as high cholesterol, diabetes, obesity, tobacco use, and sedentarism.”

High blood pressure is a major risk factor for heart disease and stroke – the two leading causes of death in the world. While the stroke rate continues to slide in people 55 and older, the reverse is happening among younger adults starting in their mid-to-late 30s, according to new research released earlier this year.  The new data concerns the medical community, which has strongly promoted the treatment and prevention of stroke’s underlying risk factors, such as high blood pressure, high cholesterol and diabetes.

A blood pressure of less than 120/80 will still be considered normal, but levels at or above that, to 129, will be called “elevated,” according to a statement by the AHA. The first number in a blood pressure reading (systolic) refers to the pressure on blood vessels when the heart contracts, and the second with the pressure as the heart relaxes between beats (diastolic).

The new guidelines have been in the works for about three years and are based on hundreds of studies and clinical trials. But authors of the new guidelines are not suggesting that more people will necessarily need to take medication to control hypertension. Published Monday in the AHA’s journal Hypertension, the new guidelines emphasize that doctors need to focus on “a whole framework of healthier lifestyle changes for patients” — through more nutritious eating and regular exercise — to help people take control of their blood pressure earlier.

“Yes, we will label more people hypertensive and give more medication, but we will save lives and money by preventing more strokes, cardiovascular events and kidney failure,” said Kenneth Jamerson, M.D., professor of internal medicine and hypertension specialist at the University of Michigan Health System. He is one of 21 experts on the guideline writing committee. “If you are going to put money into the healthcare system, it’s to everyone’s advantage if we treat and prevent on this side of it, in early treatment.”

High blood pressure is when the force of blood pushing against vessel walls is too high. This added pressure causes the heart to work harder and blood vessels to function less effectively. Over time, the stress damages the tissues within arteries, which can further damage the heart and circulatory system.

Hypertension is sometimes referred to as the “silent killer” because there are often no obvious symptoms. It accounts for more heart disease and stroke deaths than almost all other preventable causes and is second only to smoking.