You may not have had high blood pressure Sunday, but you may have it today. Even if your blood pressure hasn't changed a smidge. What's up?
The rules shifted Monday. It used to be that we encouraged people to adopt healthy behavior to keep their blood pressure down but didn't label someone as having hypertension until systolic blood pressure (the top number) exceeded 140 millimeters of mercury and/or the diastolic blood pressure (the bottom number) exceeded 90 mm Hg. Lots of people watch those numbers closely.
Now the American College of Cardiology and the American Heart Association have updated blood pressure guidelines that move the goal post for many people.
If you have heart disease, chronic kidney disease or diabetes, then your target now for systolic blood pressure has moved down to 130 and for diastolic blood pressure to 80. Same goes if your 10-year risk of having a heart attack or stroke is greater than 10 percent (determined by a calculator found here).
The focus on people who have a high likelihood of heart disease and stroke is an effort to maximize the health gains from risk reduction.
To decide whether the blood pressure targets should change, the ACC and AHA assembled 21 experts who reviewed all the relevant studies, including a landmark study by the National Institutes of Health that supported lower target levels. In the end, they were unanimous in endorsing a lower standard, believing it would reduce risk and be worth the extra medications for people at high risk. Importantly, they did not change the standard for low-risk individuals.
The big change is that we will end up labeling many more people with hypertension and recommending drug treatment for many more people, too. The hope is that more aggressive treatment will reduce life-threatening heart attacks and strokes.