Doctors explain why blood pressure guidelines changed

Nearly half of Americans are considered to have high blood pressure! That's the big headline this week - following new blood pressure guidelines issued by the American Heart Association. (11-14-17)

Under new Guidelines, developed by the American Heart Association and the American College of Cardiology and nine other health professional organizations, nearly half of American adults and nearly 80 percent of those aged 65 and older will need to take steps to lower their blood pressure.

The nation's leading heart experts are raising awareness of the life-altering consequences of uncontrolled high blood pressure and to motivate people to talk with their doctor and recommit to a treatment plan.

Hypertension, also known as high blood pressure is the leading risk factor for stroke or heart attacks. Yet only half of these people diagnosed have the condition under control.  

“I wasn’t surprised to see the new benchmark and that many people considered to be hypertensive, our country is becoming progressively obese and sedentary, we also still have a significant number of smokers in this country,” Doctor Abe DeAnda said. He is a professor and chief of cardiovascular surgery at University of Texas/Galveston Medical Center.

Even though doctors have been able to reduce mortality and morbidity and improve outcomes, cardiovascular disease remains the leading cause of death among Americans. These new guidelines have been put into place to reduce the impact of heart disease, hypertension, and stroke in our country. 

“We made reductions in mortality and morbidity, in stroke and renal disease but not to the extent that we thought it would be, so the question is why - why have we not achieved that?" DeAnda explained. "So I think the American Heart took a big look inside themselves and asked what are the big factors, and hypertension was one of them."

The American Heart Association is honing down on the modifiable risk factors associated with heart disease and high blood pressure is a major and measurable risk factor.

“We can’t change our sex, our age, or our genetics but we can change our blood pressure," he said.

According to DeAnda, there are a number of trials and longitudinal ongoing studies where data is continuously being collected. 

“There is lots of data out there - that is always being collected - the American Heart Association is able to look at those data bases and get the answers from that”.

While most people know their blood pressure numbers, many don't feel an urgency to manage it because there are often no signs or symptoms associated with high blood pressure. However, if high blood pressure is left untreated, the damage that it causes in a person's circulatory system could contribute significantly to additional health problems. 

Doctors recommend patients to work with their doctor to understand their blood pressure numbers and develop a treatment plan if their numbers are high. Under the relatively more lenient standard that had prevailed for years, close to half of patients did not manage to get their blood pressure down to normal.

High blood pressure will now be defined as 130/80 for anyone with a significant risk of heart attack or stroke.  The previous guidelines defined high blood pressure as 140/90. By lowering the definition of high blood pressure, the guidelines recommend earlier intervention to prevent further increases in blood pressure and the complications of hypertension.

Your systolic pressure is the top number and represents the forward moving oxygenated blood from your heart to your body.  It describes the pressure on blood vessels when the heart contracts. The bottom number represents the pressure when your heart is resting and filling with blood between beats.   If the bottom number is too high, you can damage your heart and coronary arteries.

Doctors say to be cautious. Too low of a blood pressure is not always ideal and varies from person to person.  You need to have a certain amount of pressure to perfuse your brain and the rest of your body. 
“A little old lady may have a systolic pressure of 85 and be ok with that, but an NFL player may be fatigued and not be able to get out of bed with that blood pressure. Everyone has a minimum they have to surpass,” DeAnda explained.

Doctors say is it going to be hard to meet those blood pressure goals. They are encouraging patients to take charge of their health.  But they worry that people will not take their prescribed medication.

Lifestyle changes like diet and exercise are the first line of defense and can help many patients lower blood pressure, but many of the newly diagnosed are likely to wind up medicated.

“I think there is going to be some pushback,” DeAnda said. “I worry people will not take medication because they think it’s all arouse to generate more money for pharmaceutical companies, we have seen that with cholesterol guidelines, with the statins –people said it is all about the money Pfizer can make for the drugs”

DeAnda said at the end of the day, the change is for the better health of Americans.

“Doctors want or people to eat healthy and exercise,” he said. 

The good news for patients is that nearly all the drugs used to treat high blood pressure are generic now. Many cost pennies a day, and most people can take them without side effects.

“The holidays are around the corner and it can be a challenging time of year for health but somehow we get through it.”  DeAnda said, “After you have a big meal it is not a bad idea to get out of the kitchen and go for a walk before you plop down to watch a football game.”
            
Doctors recommend taking all things, including stress in moderation.

“Besides our diet is family stress, shopping stress and all of the other stresses, people have to keep that in mind,” DeAnda said “Sometimes you just have to walk out of the kitchen, get away from a stressful environment if you have to – that will jack up your blood pressure just as easily.” 
 

© 2017 KREM-TV


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