Following an extensive review of recent research, the United States has released updated guidelines for managing high blood pressure, aiming to further reduce the risks of heart disease and dementia. This revision, a collaboration among the American Heart Association (AHA), the American College of Cardiology (ACC), and other reputable organizations, replaces the previous guidelines established in 2017.
The revised guidelines primarily focus on healthcare professionals, particularly concerning individuals already classified as high-risk, those with pre-existing health conditions, and pregnant women. Importantly, the recommendations remain applicable to all adults, regardless of their current health status.
Innovative Risk Assessment Tool Introduced
A key addition to the updated guidelines is the introduction of the PREVENT (Predicting Risk of CVD Events) score. This cardiovascular risk calculator utilizes data from over 3.2 million diverse individuals collected between 1992 and 2022. The tool aims to provide a more comprehensive assessment of an individual’s risk for various cardiovascular complications.
Research increasingly indicates that high blood pressure significantly heightens the risk of cardiovascular and neurological diseases, as well as complications affecting the kidneys, eyes, and overall metabolism. The new guidelines emphasize, “High blood pressure is the most prevalent and modifiable risk factor for the development of cardiovascular diseases, including coronary artery disease, heart failure, atrial fibrillation, stroke, dementia, chronic kidney disease, and all-cause mortality.”
Blood pressure is measured in two parts: systolic blood pressure, represented by the larger number, and diastolic blood pressure, represented by the smaller number. Normal blood pressure is defined as below 120 mm Hg systolic and 80 mm Hg diastolic. Elevated blood pressure falls within the range of 120-129 mm Hg systolic and below 80 mm Hg diastolic.
Stage 1 high blood pressure is categorized as 130-139 mm Hg systolic or 80-89 mm Hg diastolic, while Stage 2 is classified as anything exceeding those figures. Immediate medical attention is advised for readings above 180 mm Hg systolic or 120 mm Hg diastolic, particularly if accompanied by symptoms such as chest pain or shortness of breath. Once classified as high blood pressure, medication may be necessary, although in Europe, treatment typically commences only at the 140/90 mm Hg threshold unless other health factors are present.
Goals and Lifestyle Recommendations
The overarching goal of the new guidelines is to achieve a blood pressure of less than 130/80 mm Hg for all adults, with additional considerations for those in institutional care, those with limited predicted lifespans, and pregnant individuals.
Lifestyle recommendations remain unchanged and apply universally: maintain regular physical activity, adhere to a diet low in sodium, consume alcohol in moderation, and manage stress effectively. Engaging with friends and family can also be beneficial for maintaining healthy blood pressure levels.
The guidelines advocate for a collaborative approach among clinicians, community leaders, and health systems. They stress the importance of implementing screening for all adults within communities and adhering to evidence-based recommendations for the prevention and management of high blood pressure to enhance control rates.
The updated guidelines have been published in the journals Hypertension and Circulation, providing a comprehensive framework for addressing high blood pressure and its associated risks.
