New guidelines from the American College of Cardiology and the American Heart Association have lowered the blood pressure readings at which hypertension is diagnosed in the United States.
The term ‘prehypertension’ has been scrapped, and instead the blood pressure levels previously referred to as ‘prehypertension’ have been divided into two new categories of:
- Elevated BP if your upper reading (systolic pressure) is between 120 and 129 mmHg but your lower reading (diastolic pressure) remains less than 80 mmHg
- Stage 1 hypertension if your systolic pressure is between 130 to 139 mmHg OR your diastolic pressure is between 80 to 89 mmHg.
So, if your blood pressure is anywhere between 130/80 mmHg or above you officially have hypertension.
The new blood pressure guidelines
The new definitions have come about because of increasing recognition that having an elevated blood pressure of 120/80 mmHg or more is associated with increased long-term health risks. Your artery walls receive a pounding every time your heart beats, which causes microdamage that slowly leads to hardening and furring up of the arteries. As a result, having an elevated blood pressure can double your long-term risk of a heart attack compared with someone whose blood pressure remains in the healthy range (ie below 120/80 mmHg).
New US Definition
|Less than 120 mmHg||Less than 80 mmHg||Normal BP||Normal BP|
|120-129 mmHg||Less than 80 mmHg||
|130–139 mmHg||80–89 mmHg||Stage 1 hypertension|
|140–159 mmHg||90–99 mmHg||Stage 1 hypertension||Stage 2 hypertension|
|> 160 mmHg||>100 mmHg||Stage 2 hypertension|
The new guidelines mean the number of people diagnosed with high blood pressure will increase dramatically. With the old definition of hypertension, an estimated 31.9% of adults had hypertension – equivalent to 72,200,000 in the United States alone. With the new definition, an estimated 45.6% of adults have hypertension – 103,300,000 people, which is a massive jump.
Not everyone will need medication, however. Those now diagnosed with elevated blood pressure, or stage 1 hypertension will first be advised to follow diet and lifestyle changes, such as those feature on this website:
- Lose any excess weight
- Follow a DASH-style diet
- Cut back on sodium/salt intake
- Increase your dietary potassium intake
- Exercise regularly – ideally every day
- Limit your alcohol intake.
The target for blood pressure management has also reduced from less than 140/90mmHg to a new treatment goal of achieving a blood pressure of less than 130/80 mmHg.
If your blood pressure is raised, self-monitoring is key to maintaining good control.
Click here for advice on choosing a blood pressure monitor to use at home.
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