| News - Hypertension Week of May 18, 2003/ Vol. 2 No. 20 |
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Blood Pressure Standards for What is Considered Healthy Lowered |
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The National Heart, Lung and Blood Institute (NHLBI) has released new clinical practice guidelines that recognize that damage to the arteries begins at lower blood pressure levels than previously considered optimal. The guidelines are part of the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure and represent an update from the previous ones issued in November 1997. "The bottom line is that Americans must change how they think about blood pressure," said Dr. Ed Roccella, coordinator of NHLBI's National High Blood Pressure Education Program. "The sooner they take action, the better. It's vital that they adopt a heart-healthy lifestyle early, even if their blood pressure is normal." The
guidelines recognize that the risk of death from heart disease and stroke begins
to increase even at blood pressures as low as 115 over 75 mmHg and that it doubles
for each 20 over 10 mmHg increase beyond that mark. Previously, the normal or
optimal mark was 120/80 mmHg. The guidelines do not recommend drug therapy for those with prehypertension unless it is required by another condition, such as diabetes or chronic kidney disease. But the report advises them as well as those with normal blood pressures to make any needed lifestyle changes. Such changes include losing excess weight, exercising, limiting alcoholic beverages and following a heart-healthy eating plan, including cutting back on salt and other forms of sodium. The report also recommends that people quit smoking. As in the 1997 guidelines, the new report recommends Americans follow the DASH -- Dietary Approaches to Stop Hypertension -- eating plan, which is rich in vegetables, fruit, and nonfat dairy products. The guidelines recommend the use of a diuretic, either alone or in combination with another drug class, as part of the treatment plan in most patients. The guidelines also list other drug classes that have been shown to be effective in reducing hypertension's cardiovascular complications and that may be considered to begin therapy: angiotensin converting enzyme (ACE) inhibitors, angiotensin receptor blockers, beta-blockers, and calcium channel blockers. The
new report also notes that people need two and, perhaps, three or more medications
to lower blood pressure to the desired level. Other
sources: NHLBI |
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