“The previous guideline defined systolic blood pressure from 130 to 139 and diastolic blood pressure from 80 to 89 as prehypertension,” said Terry Kang, MD, UnityPoint Clinic Family Medicine Bowman Woods. “The same bracket is now called stage one hypertension. This means about half of the patients we see are now defined as hypertensive.”
“These new guidelines stem from multiple studies that show lower blood pressure will reduce further chances in the future of heart attacks and strokes,” said Georges Hajj, MD, UnityPoint Health – Cardiology. “We are looking at those patients that are at increased risk of having a heart attack or stroke in the future. Those include individuals who already have heart disease, diabetes and those with multiple other risk factors. It means they need to be doing something to get their blood pressure under control.”
Higher blood pressure not only increases an individual’s chance of having a heart attack or stroke. It also places stress on other body parts such as the kidneys, leading to early failure. When combined with other chronic illnesses such as diabetes, the risks are much higher.
“When I see someone for high blood pressure for the first time, we discuss their diet, exercise and life routines,” said Dr. Kang. “If their blood pressure is borderline, this may be all that’s needed but we keep an eye on it. However, if their blood pressure remains high over a period of time, we continue lifestyle modifications but also discuss adding medications.”
“A large number of patients in this prehypertension category are now needing medications to reach the new blood pressure goal,” said Dr. Hajj. “The evidence is there that risks of heart attack and stroke over five to 10 years is substantially lower and therefore survival is longer if we achieve that new goal in this particular group of patients.”
“One thing to mention is blood pressure can fluctuate throughout the day,” said Dr. Kang. “It can also go up and down depending on your mood or activity. The best way to keep track of your blood pressure is by taking it several times throughout the week. It’s also important to note any symptoms, such as dizziness or headaches and share all of this information with your health care provider.”
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