For decades, doctors encouraged us to strive for blood pressure readings of 120 over 80, but last December, the American Medical Association revised its guidelines. Now, the threshold for healthy blood pressure levels has been raised to 140 over 90 for adults age 30 to 59 and 150 over 90 for adults age 60 and older. Why the sudden change?
Hypertension can do severe damage to internal organs, including the heart and kidneys, without causing noticeable symptoms. For that reason, it’s long been known as a silent killer. It’s still just as important as ever to know your blood pressure numbers and take steps to keep your blood pressure under control. But a systematic review of clinical trials found that there’s little benefit to treating low to moderate hypertension. For some patients, aggressive hypertension treatment could do more harm than good.
What Is Blood Pressure and How Is It Measured?
The term “blood pressure” refers to the force that blood exerts on the walls of the arteries as it is expelled from the heart. Your blood pressure numbers are recorded in millimeters of mercury or mm Hg and are often written out as a fraction, for example, 120/80 to mean 120 over 80. The top number is your systolic blood pressure; that’s the pressure your blood exerts against your arteries when it is forced out of the heart as the heart muscle contracts. The bottom number is your diastolic blood pressure; that’s the pressure your blood exerts against your arteries in the brief span of time when your heart muscle is at rest between beats. Because your heart is at rest, this bottom number is much lower.
The previous hypertension guidelines stated that “normal” blood pressure fell below 120 for systolic pressure and below 80 for diastolic pressure. If one of those numbers is too high but the other one is normal, you’re still considered to have hypertension. Hypertension, or high blood pressure, was diagnosed if your blood pressure was higher than 140 over 90. Readings of 120 to 139 over 80 to 89 were considered “pre-hypertension.”
Why Change the Guidelines?
Now, doctors are shooting for blood pressure readings lower than 140 over 90 for healthy adults age 30 to 59 and adults of all ages with kidney disease or diabetes. Target blood pressure rates for older adults have been raised to 150 over 90. That’s because a review of the clinical research into the benefits of blood pressure treatment has found that there’s no clear benefit to blood pressure treatment for people with pre-hypertension.
Dr. Denzil Moraes, a cardiologist at Louisiana Cardiology Associates at Our Lady of the Lake Physician group, told The New Orleans Advocate, “Most doctors want their patients (at or below) 140 over 90. So 120 over 80 is no longer the case. It’s more like 140 over 80 now.” Dr. Moraes did point out that the new guidelines are controversial, but he agreed that administering blood pressure medication according to the old guidelines didn’t bring noticeable benefits to patients.
Furthermore, patients over 60 can suffer an increased risk of falls and injuries when hypertension is too aggressively treated, according to a study published in the April 2014 edition of JAMA Internal Medicine. Dizziness is a common side effect of blood pressure medication, and it can lead to falls and, in older, frailer patients, broken bones and other injuries. That’s why the new blood pressure thresholds for older adults have been raised to 150 over 90. At those levels, older patients can still avoid the organ damage that occurs as a result of high blood pressure, without the increased risk of dizziness and falls.
Control Your Blood Pressure
Just because the AMA has changed the guidelines for hypertension treatment, doesn’t mean that blood pressure medication is no longer necessary. You should know what your blood pressure numbers are — you can get free blood pressure readings at pharmacies and clinics. If your numbers are too high, your doctor will want to monitor your blood pressure for a period of time and may prescribe medication. You can save money on your hypertension medication like generic Labetalol by ordering it from our online pharmacy.
Lifestyle changes can also go a long way toward helping you control your blood pressure. Too much sodium in your diet can raise your blood pressure, so make sure you’re within daily limits for sodium consumption. Foods rich in potassium like bananas, avocados, baked potatoes and white beans can help lower your blood pressure by removing sodium from your blood.
Staying active can also help keep your blood pressure under control. Get 30 minutes of exercise most days a week. Exercise strengthens your heart muscle so that it doesn’t have to work as hard to push blood through your arteries; this can reduce your blood pressure. Stress can also raise your blood pressure, so look for ways to manage your stress, like meditation or exercise. Avoid tobacco and limit your alcohol use, and of course, take your blood pressure medication as prescribed. New guidelines from the AMA have changed the way doctors approach blood pressure treatment, but that doesn’t mean you won’t need medication to treat your high blood pressure.