New Blood Pressure Guidelines: What you Need to Know

 

Understanding your blood pressure reading

Making sense of your blood pressure reading can be tricky, but we’ve broken it down to help you better understand what the numbers mean.

A blood pressure reading involves two numbers, one over the other. For example, a reading might be presented as 120/80.

Systolic pressure, the top number, is the pressure on the arteries when the heart beats and pumps blood.

Diastolic pressure, the bottom number, is the pressure on the arteries in between heartbeats.

Although both systolic and diastolic measures are important, research has found that systolic pressure is a strong predictor of heart problems caused by high blood pressure, especially among older adults. Normal blood pressure is less than 120/80.

New blood pressure guidelines

In late 2017, the American Heart Association and the American College of Cardiology announced updated high blood pressure guidelines. The new guidelines are based, in part, on research carried out and funded by the National Heart, Lung, and Blood Institute (NHLBI) at NIH.

Under the updated AHA/ACC guidelines, if you have systolic blood pressure rates of 130 and higher you are considered to have high blood pressure. The old guidelines set high blood pressure rates at 140 or higher.

These new guidelines were informed by a number of clinical studies that showed that lifestyle changes can help high-risk individuals reduce their blood pressure—and may ultimately save lives.

Those changes include heart-healthy diets, weight loss, and exercise as key first steps in reaching a lower blood pressure target.

One study that helped inform the guidelines was the SPRINT (Systolic Blood Pressure Intervention) trial, which was supported by NHLBI.

SPRINT studied 9,300 adults, aged 50 and older, at risk for heart disease from around the U.S. It showed that achieving a lower blood pressure goal of 120 mm Hg (instead of 140) reduced the rate of heart events by about 25 percent and the overall risk of death by 27 percent.

Talk to your health care provider

You can measure your blood pressure at home with a monitor and in your health care provider’s office. Some people have higher blood pressure readings at the doctor’s office due to the stress that appointments can create. It’s known as “white coat hypertension.”

Be sure to talk to your health care provider about your blood pressure reading and any follow-up steps you need to take.

SOURCE: National Heart, Lung, and Blood Institute: Blood Pressure Reading Opens new window

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Systolic Blood Pressure Intervention Trial (SPRINT) Study

 

In adults age 50 and older who had high blood pressure and at least one additional cardiovascular disease risk factor, but who had no history of diabetes or stroke, SPRINT showed that treating to a target systolic blood pressure of less than 120 mm Hg reduced rates of high blood pressure complications, such as heart attack, heart failure, and stroke, by 25 percent. Compared with the standard target systolic pressure of 140 mm Hg, treating to less than 120 mm Hg also lowered the risk of death by 27 percent. In 2015, the SPRINT Research Group published its findings in the New England Journal of Medicine.

The cardiovascular benefits of the lower systolic blood pressure target were consistent in all groups of people included in SPRINT, regardless of gender, race, age, or pre-existing CKD. To achieve the target systolic blood pressure of less than 120 mm Hg, the first treatment group received three medicines on average. The second treatment group received two medicines to treat to the target systolic blood pressure of less than 140 mm Hg. Participants had high levels of satisfaction with treatment and adherence to medicines regardless of which treatment group they were in.

In the lower blood pressure group, there were expected side effects from blood pressure medicines, such as lower blood levels of potassium and sodium. Treating to the target systolic blood pressure of less than 120 mm Hg also showed an increase in complications due to low blood pressure such as fainting; however, there was not an increased risk of falls. Overall, the benefits in reducing the risk of cardiovascular disease and death outweighed the potential side effects of treating to a lower blood pressure target.

SPRINT included a large group of adults age 75 and older, and a separate analysis confirmed that treating to a lower blood pressure target reduced complications of high blood pressure and saved lives in older adults, as with the overall study population, even for older study participants who had poorer overall health. This was an important finding because a large percentage of the U.S. population age 75 and older have high blood pressure.

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