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The New Normal in High Blood Pressure

New Guidelines Target Hypertension Before It Starts

WebMD Health News

May 14, 2003 -- Nearly one in four adults in the U.S. who once thought they had normal blood pressure levels are now considered part of a new risk group category called "prehypertension," according to new federal high blood pressure guidelines announced today.

The new prehypertension category includes about 45 million men and women who have a systolic blood pressure (the top number) between 120 to 139 mm Hg or a diastolic blood pressure (the bottom number) of 80 to 89 mm Hg.

Although officials do not recommend that people who fit into this prehypertension category start taking blood pressure-lowering drugs, they do call for these people to make heart-healthy lifestyle changes to reduce their risk of heart disease, stroke, kidney damage, and other complications.

The new recommendations also call for wider use of diuretics ("water pills") for people with high blood pressure -- blood pressure levels above 140/90 mm Hg. They also recommend combination treatment using more than one blood pressure drug for people with severe high blood pressure -- blood pressure of 160/100 or higher.

It's the first major revision of national blood pressure guidelines since 1997. The new guidelines will also appear in the May 21 issue of the The Journal of the American Medical Association. -->

New Blood Pressure Guidelines
ClassificationSystolic
(top number)
   Diastolic
(bottom number)
Normal120 or lower AND 80 or lower
Prehypertensive120 - 139 OR 80 - 89
High140 and higher OR 90 and higher
Blood pressure can be managed through lifestyle changes.

-->

Researchers say the revisions were necessary because recent studies have shown that by age 55, men and women who don't already have high blood pressure have a 90% chance of developing it later.

"In addition, we have found that damage to arteries begins at fairly low blood pressure levels --levels which were previously considered 'normal,'" says Aram Chobanian, MD, chair of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure, which compiled the report.

Chobanian says research has shown that the risk of death due to heart attack and stroke increases rapidly with rising blood pressure levels, starting at levels as low as 115/75 mm Hg. For every 20/10 mm Hg rise in blood pressure above this level, the risk of death from heart problems doubles.

That's why the report recommends people who fall into the new prehypertensive category make healthy lifestyle changes to lower their blood pressure and prevent the development of high blood pressure. Those steps include:

  • Losing weight if you are overweight
  • Getting regular exercise
  • Adopting the DASH (dietary approaches to stop hypertension) eating plan that emphasizes a low-fat and low-salt diet rich in fruits and vegetables
  • Cutting back on salt
  • Limiting alcohol consumption
  • Quitting smoking

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