* NEWSWORTHY Y Recheck
Think your blood pressure levels are fine for now? You might want to think again, as new guidelines have lowered the level at which heart associations recommend taking action to treat hypertension. In November, the American College of Car-
diology/American Heart Association issued new guidance for when to treat high blood pressure, lowering the cutpoint from 140/80 to 130/80 — effectively shifting 31 million American adults from pre-hypertensive to a full-blown diagnosis of hypertension, many of them younger adults. The task force did not change the cutpoint for what is considered normal blood pressure (less than 120/80). Nearly half of all American adults (46
percent) would be considered hypertensive under the new guidelines — 14 percent more than previously believed to fit this category. The authors of the new guidelines expect that the number of men under age 45 who have high blood pressure will triple under this defi- nition and the number of women in this age category will double. However, most of those who meet the new
criteria won’t need medication, says Paul K. Whelton, MB, MD, MSc, FACC, professor at Tulane University School of Public Health and Tropical Medicine/School of Medicine in New Orleans, and lead author of the new guide- lines.
“It does not change dramatically the
number of people needing drug therapy,” Dr. Whelton says. “Mostly what they need is a lifestyle change. That’s the underlying cause of most hypertension — it’s due to poor diet or lack of physical activity.” He says that the writing committee reexam- ined the guidelines in light of a wealth of new research published since the last comprehen- sive analysis was conducted in 2003. The classifications for hypertension had not
16 | MATTERS OF HEALTH
our Numbers You might need to treat your blood pressure after all
been changed since 1993. The cutpoint was lowered to encourage people to take steps to lower their blood pressure if high, and, for those at risk, to prevent any elevation. “We now have a lot more precise informa- tion on risk and a lot of new treatment trials,” Dr. Whelton says. On the risk side, he says, “It’s now very clear that people with average systolic levels of 130 or more are already at pretty high risk. They generally have double the risk of having a heart attack or stroke compared to those with levels in the normal range. We know from clinical trials that getting pressures down below that level is really beneficial.” There are three major factors that con-
tribute to the risk of having a heart attack or stroke, says Dr. Whelton: diet, physical activ- ity and smoking. Each of these risks can be reduced. If you smoke, talk to your healthcare team about starting a cessation plan. Smoking not only increases blood pressure levels, it de- creases your tolerance for exercise, according to the American Heart Association. And exercise is key to lowering blood pres-
sure levels, says Dr. Whelton — especially aerobic exercises, such as walking, running or swimming. Other activities, such as weight lifting, have also been shown to help. “But any increase in physical activity is beneficial,” he says.
Losing weight, if you are overweight, is also
important, he says. This can be done through both exercise and diet. “Getting to an ideal weight is the goal, but any weight loss is beneficial,” he says. As with exercise, says Dr. Whelton, there’s no perfect method for reach- ing your goals, though some are better than others. “Any healthy diet is good,” he says, but the DASH diet — which is rich in fruits and veg-
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