AHA re-defines high BP in its new guidelines: “130 is the new high”
New guidelines from the American Heart Association (AHA) and the American College of Cardiology (ACC) for detection, prevention, management and treatment of high blood pressure have redefined high blood pressure for first time in 14 years. The guidelines were presented November 13, 2017 at AHA’s 2017 Scientific Sessions conference in Anaheim
In a change from the older definition of 140/90 and higher, high BP is now defined as systolic BP 130 mm Hg and higher, or diastolic BP 80 and higher. By lowering the definition of high BP, the guidelines recommend earlier intervention to prevent further increases in blood pressure and the complications of hypertension. The importance of using proper technique to measure BP has been emphasized. Blood pressure levels should be based on an average of two to three readings on at least two different occasions.
The new guidelines have eliminated the category of prehypertension, which was used for blood pressures with a top number (systolic) between 120-139 mm Hg or a bottom number (diastolic) between 80-89 mm Hg. People with those readings now will be categorized as having either Elevated (120-129 and less than 80) or Stage I hypertension (130-139 or 80-89).
Previous guidelines classified 140/90 mm Hg as Stage 1 hypertension. This level is classified as Stage 2 hypertension under the new guidelines.
High blood pressure should be treated earlier with lifestyle changes and in some patients with medication at 130/80 mm Hg rather than 140/90.
Medication for Stage I hypertension should be prescribed if a patient has already had a cardiovascular event such as a heart attack or stroke, or is at high risk of heart attack or stroke based on age, the presence of diabetes mellitus, chronic kidney disease or calculation of atherosclerotic risk.
Blood pressure categories in the new guideline are:
· Normal: Less than 120/80 mm Hg;
· Elevated: Top number (systolic) between 120-129 and bottom number (diastolic) less than 80;
· Stage 1: Systolic between 130-139 or diastolic between 80-89;
· Stage 2: Systolic at least 140 or diastolic at least 90 mm Hg;
· Hypertensive crisis: Top number over 180 and/or bottom number over 120, with patients needing prompt changes in medication if there are no other indications of problems, or immediate hospitalization if there are signs of organ damage.
(Source: AHA News Release, November 13, 2017)