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Thread: What the New Blood Pressure Guidelines Mean for You

  1. #1

    Default What the New Blood Pressure Guidelines Mean for You

    https://www.consumerreports.org/high...re-guidelines/

    By Hallie Levine, November 13, 2017

    The percentage of Americans with high blood pressure jumped from 32 percent to 46 percent today, when the American Heart Association and the American College of Cardiology issued new guidelines for the condition.
    But that doesn't mean that all those people suddenly need to be on blood pressure medication, our experts say.

    On Monday, the AHA and ACC redefined high blood pressure as a reading of at least 130 millimeters of mercury for the systolic (top) number or 80 for the diastolic (bottom) number. Previously, the cutoffs had been a top number of 140 and a lower number of 90.

    The new definition will especially affect younger people, tripling the number or men under age 45 considered to have hypertension and doubling the number of women under age 45 with that condition.
    The new definition also eliminates the category of “pre-hypertension," which had been considered an upper reading in the 130s and a lower reading in the 80s.
    “We now know that a blood pressure level between 130-139/80-89 doubles your risk of cardiovascular complications such as a heart attack compared to people whose blood pressure is under 120/80,” says Paul Whelton, M.D., lead author of the guidelines and the Show Chwan professor of global public health at the Tulane University School of Public Health in New Orleans. That’s because damage to blood vessels begins as soon as blood pressure is elevated.

    For most people who find themselves in that range, however, changes in diet and exercise routine—not drugs—are what's needed to bring those numbers back down to normal.

    Understanding the New Guidelines
    The new guidelines put blood pressure readings in five different categories:

    • Normal. Less than 120/80.
    • Elevated. A top number between 120 and 129 or a bottom number less than 80.
    • Stage 1. A top number between 130 and 139 or a bottom number between 80 and 89.
    • Stage 2. A top number of 140 or higher and a bottom number of at least 90.
    • Hypertensive crisis. A top number over 180 or a bottom number over 120.

    Our experts say the reclassification of high blood pressure is a good thing.

    “Flagging elevated blood pressure earlier will hopefully motivate people to make lifestyle changes—such as eating a heart-healthy diet and exercising—that can dramatically lower blood pressure in the long term,” says Consumer Reports' chief medical adviser Marvin M. Lipman, M.D.

    But while it’s important to regularly monitor your blood pressure and work on lifestyle changes if you’re above the 120/80 range, "it’s also crucial not to rush to medication," Lipman says.

    Drug treatment to lower blood pressure is only associated with a reduced risk of death and cardiovascular disease in people whose baseline systolic blood pressure is 140 or higher, according to a review of the research published Monday in the medical journal JAMA; there’s no strong evidence that such pills will help people with lower numbers.

    And many of the drugs used to treat high blood pressure carry risks, including dizziness and impaired kidney function. When doctors work to reduce the blood pressure of elderly patients too aggressively, for example, they put those patients at a “heightened risk for falls and fractures,” says Steven Nissen, M.D., chairman of cardiovascular medicine at the Cleveland Clinic.

    Here, our experts’ advice on how to control your blood pressure in light of the new guidelines.

    1. Know Your Blood Pressure Numbers
    Even before the new recommendations were issued, 13 million Americans were walking around with undiagnosed high blood pressure, according to the Centers for Disease Control and Prevention.

    And left unchecked, excessive pressure can damage blood vessels throughout the body and increase your risk for heart attacks, strokes, and heart failure as well as kidney damage, vision loss, and arterial blockages.

    That’s why it’s important to detect high blood pressure early, so you can adjust course before the damage occurs.

    Have your blood pressure checked at least once every two years, and more often if you’re 50 or older or have other risk factors for hypertension. For most people, it’s a good idea to have it done every time you visit a healthcare provider.

    If your initial reading is elevated, don’t panic. That can be due to a number of factors, including stress or caffeine. (Read more about how to get accurate readings.) If your blood pressure is high and you have no history of high readings, your doctor may take another reading after about 5 minutes and, if that's still high, another in a couple of weeks to confirm.

    It’s also a good idea to invest in a home blood pressure monitor. Sometimes, people who have high blood pressure at their doctor’s office actually have normal blood pressure in other settings, like at home, a condition known as “white-coat hypertension.” And if you are diagnosed with high blood pressure, a home monitor may help you get it under control, according to a study published in JAMA.

    2. Make Lifestyle Changes
    If your blood pressure is over 120/80, lifestyle changes are in order, says Mary Norine Walsh, M.D., president of the American College of Cardiology and a cardiologist at St. Vincent Heart Center in Indianapolis.

    A slightly elevated reading doesn’t mean that you are necessarily going to develop high blood pressure, or that you should consider medication, but it does mean you should make some broad-based lifestyle changes, Walsh says.

    Regular exercise can lower your systolic pressure by up to 9 points, and losing 11 pounds can reduce it by 2.5 to 10 points. Avoiding excess sodium (anything beyond 2,400 mg in a day) can also lower it between 2 and 8 points in some people.

    3. Don't Rush to Drugs
    Even if your blood pressure is elevated—above 130/90—you should generally try lifestyle changes first.

    Consumer Reports recommends considering drugs only if your blood pressure readings are over 140/90 for most adults and over 150/90 if you’re older than 60—and if several months of diet and lifestyle changes haven't sufficiently lowered your readings.
    “One of the best prescriptions for high blood pressure is to adopt a healthy lifestyle,” Lipman says.

    A combination of reduced sodium intake and the DASH diet (rich in fruits, vegetables, and whole grains, low or fat-free dairy, fish, poultry, beans, seeds and nuts), for example, dramatically lowers blood pressure in adults with hypertension, according to a Beth Israel Deaconess Medical Center study presented this month at the American Heart Association Scientific Sessions 2017 annual meeting.

    4. If You Do Need Drugs, Choose Carefully
    Doctors use several different kinds of drugs to lower blood pressure, and for people with a reading above 150 it can take a combination to control the problem.

    Still, it usually makes sense to start with the oldest, safest, and least expensive drug: diuretics, or water pills, such as chlorthalidone or hydrochlorothiazide.

    These can drive up blood sugar levels, however, Nissen says, so if you have type 2 diabetes or are at risk of it, you may need to be monitored closely by your doctor or consider another drug, such as an ACE inhibitor or calcium channel blocker.

    5. If You Take BP Drugs, Check in Regularly With Your Doctor
    One side effect of any blood pressure drug is dizziness, which can increase risk of falls, especially in older adults.

    “It’s best to be super cautious, especially among the elderly," Nissen says. "I personally start with the lowest dose of medication possible and then reassess in a couple of weeks."
    Individuals undergoing intensive blood pressure lowering are also more likely to experience a decline in kidney function, according to a study published earlier this month in the Clinical Journal of the American Society of Nephrology. That’s why it’s important to make sure that your physician periodically checks your kidney function and potassium levels, Lipman says.

    If you’ve been on medication for a while and have gotten your blood pressure to target levels, consider talking to your doctor about lowering your dose, especially if you’ve implemented other lifestyle changes such as weight loss and exercise.
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  3. #2

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    Means nothing to me. anything over 130 was 'pre-hypertension' already anyway.

    Doctors are going to be prescribing a lot more meds and making a lot more money though!
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  4. #3

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    So now they consider anything over average to be "high". Might be better stated as above average. Kind of meaningless as it is. It's a one size fits all approach.

    What does this really mean? More people will now have a "pre-existing" condition. More people will now require continual treatment and monitoring by the same industry that set this standard. Convenient.
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  5. #4

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    Hypertension means higher ins premiums and more meds. Crank up the pill machines

  6. #5

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    Quote Originally Posted by olehounddog View Post
    Hypertension means higher ins premiums and more meds. Crank up the pill machines
    Exactly the first thoughts of me and my wife...

  7. #6

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    In a few years 120/80 will be too high. This is being done by design. You think you can escape this lunacy? There is only one way, don't become a patient. There is no such thing as a magic pill--one pill leads to another and another and another...

    Lot's of people think salt is what elevates BP--in many cases it is sugar.
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  8. #7

    Default 30 Million Americans Were Just Diagnosed With High Blood Pressure, Here's Why...

    Why? They lowered the standards. That is also known as "Moving The Goalpost"...

    http://www.zerohedge.com/news/2017-1...sure-heres-why

    30 million Americans who woke perfectly healthy yesterday morning are now suddenly in need of expensive hypertension treatments after the American Heart Association and the American College of Cardiology decided to lower the definition of "high blood pressure" to 130/80 from the previous trigger of 140/90. According to Reuters, the change means that nearly 50% of American adults, or roughly 100 million people, now suffer from high blood pressure.

    Americans with blood pressure of 130/80 or higher should be treated, down from the previous trigger of 140/90, according to new guidelines announced on Monday by the American Heart Association and the American College of Cardiology.

    At the new cutoff, around 46 percent, or more than 103 million, of American adults are considered to have high blood pressure, compared with an estimated 72 million under the previous guidelines in place since 2003.

    High blood pressure accounts for the second-largest number of preventable heart disease and stroke deaths in the United State
    s, second only to smoking.

    A large, government-sponsored study of hypertension patients aged 50 and older showed in 2015 that death from heart-related causes fell 43 percent and heart failure rates dropped 38 percent when their systolic blood pressure was lowered below 120 versus those taken to a target of under 140.

    But patients in the 120 systolic blood pressure group had a higher rate of kidney injury or failure, as well as fainting.




    Not surprisingly, these new guidelines are expected to be a boon for pharma giants like Merck, Pfizer and Novartis who supply the world's expensive hypertension medications.

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  9. #8

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    Sales of blood pressure medications must be slumping. So Big Pharma does what they always do - generate their own illnesses to sell their drugs.
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  10. #9

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    Yep move those goalpost...'TOUCH DOWN' right into Big pHARMa's bank accounts.

    Meanwhile this pill is the start for more pills in your future.
    "Logic is an enemy and truth is a menace." ~ Rod Serling
    "Cops today are nothing but an armed tax collector" ~ Frank Serpico
    "To be normal, to drink Coca-Cola and eat Kentucky Fried Chicken is to be in a conspiracy against yourself."
    "People that don't want to make waves sit in stagnant waters."

  11. #10

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    years ago, my grandmother had a nice rant about blood pressure - that when she was younger, doctors looked at 120/80 as the standard and for every decade after 50 adding 10 points was considered normal. Then the department of health and big pharma got involved.
    Just last month, we lost my dad - who until that day never had a "heart condition" but the death certificate says otherwise. I'm pretty sure, that after getting back on his blood pressure meds after taking a break from them to see if he still needed them, the pills did their job too well. He slumped over on his golf cart and by the time a neighbor came around the block to get me, he was already gone - about an hour after he took his meds.
    I think he'd have rathered "high" blood pressure to no blood pressure
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  12. #11

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    Quote Originally Posted by opal View Post
    years ago, my grandmother had a nice rant about blood pressure - that when she was younger, doctors looked at 120/80 as the standard and for every decade after 50 adding 10 points was considered normal. Then the department of health and big pharma got involved.
    Just last month, we lost my dad - who until that day never had a "heart condition" but the death certificate says otherwise. I'm pretty sure, that after getting back on his blood pressure meds after taking a break from them to see if he still needed them, the pills did their job too well. He slumped over on his golf cart and by the time a neighbor came around the block to get me, he was already gone - about an hour after he took his meds.
    I think he'd have rathered "high" blood pressure to no blood pressure
    I am so sorry for your loss, Opal.
    "Logic is an enemy and truth is a menace." ~ Rod Serling
    "Cops today are nothing but an armed tax collector" ~ Frank Serpico
    "To be normal, to drink Coca-Cola and eat Kentucky Fried Chicken is to be in a conspiracy against yourself."
    "People that don't want to make waves sit in stagnant waters."






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