The new blood pressure guidelines which were long awaited by physicians and patients alike have finally been published. Medical experts specializing in blood pressure are unable to give an exact number of American patients who will be affected by the guidelines, but according to Dr. William B. White, president of American Society of Hypertension, it will definitely be a good many.
New Blood Pressure Guidelines
- Elevation of Lower Hypertension Threshold (for people 60 and above) from 140/90 to 150/90 mm Hg
The most important change that the new guidelines bring for the treatment of high blood pressure is the raising of the minimum blood pressure level required for those who are 60 or older to be considered as hypertension patients requiring drug treatment. The new guidelines have raised the bar to 150/90 in line with recent studies conducted by experts. Those who have authored the new guidelines are themselves leading in the field of abnormal blood pressure diagnosis and treatment, and according to them, the new goal for physicians while treating old people who have hypertension will be to lower their BP levels to below 150/90.
Basically, this alteration in the hypertension treatment threshold means that those old timers who had just started medicated treatment for systolic pressure above 140 but lower than 150 are now in the overtreatment category. According to the new guidelines, these people do not need medication for their blood pressure since it is already in the new acceptable limits. Consequently, those individuals who had a systolic BP between 130 and 140, and were being treated for prehypertension, are now completely in the green.
- There is a Lack of Medical Evidence for Creating a Fixed Threshold of Systolic BP for Drug Treatment of Those Under 60 years of Age
The studies conducted by experts on those suffering from high blood pressure have been unable to yield concrete results that provide a threshold for systolic blood pressure for those people who are below 60. Rather, the results have shown that the current evidence is not sufficient to advocate a recommendation for this considerable proportion of the populace.
The authors have, however, not completely denounced the presently accepted threshold of 140 for people below 60. According to the new guidelines, there is no need to change this threshold, in spite of the fact that it is based more on opinion than evidence. What this means for the treatment of these individuals is that the physicians need to inform them of this change in the guidelines and let them make the decision that is best for themselves.
The guidelines have also pointed out that there isn’t sufficient evidence to pinpoint a threshold for the treatment of those suffering from underlying conditions such as diabetes or kidney disease. According to the new guidelines, 140/90 should be the lower threshold for these individuals, which is higher than the more conventional BP goal of 130.
The diastolic blood pressure, according to the new guidelines, should be lower than 90, which has been proven by medical evidence for people who are 30 years or older.
- Reducing Hypertension Using Drug Treatment is not The Same as Reducing The Adverse Effects of High Blood Pressure
This assessment was made specifically for those drug treatments that deal with mild escalations in blood pressure. Although drugs definitely reduce the risk of stroke, heart attack and premature death among those who suffer from severe hypertension, studies have failed to show a similar connection in the case of drug treatments for mild hypertension. The studies directly aimed to show that treating mild hypertension with drugs can reduce the risk factor for these negative health events, but the result showed that drugs weren’t helpful at all.
The implications are that drugs affect more than one risk factors – and while they may be having a positive effect on one, they could be harming another. The patient’s overall wellbeing relies on all of these risk factors, which is why treating the mild hypertension risk factor does not yield a conclusive benefit on the patient’s health.
These studies compelled the authors of the new guidelines to withdraw endorsement of the notion that more treatment means more results.
- Other Recommendations
Besides the focus on redefining the thresholds for drug treatment, the new guidelines put emphasis on maintaining a healthy diet, keeping one’s weight in check and working out regularly. They advise patients to avoid beta-blockers as a medication for their hypertension. Furthermore, those of African descent are also advised to not go for angiotensin receptor blockers and ACE inhibitors. Thiazide-type diuretics, as well as calcium channel blockers, are also disfavored for the general populace.
To sum it all up, the new guidelines have led to a significant paradigm shift. Although, according to the authors, it wasn’t their intention to drastically alter the thresholds for high blood pressure, they have effectively done so for a very large portion of the populace. Moreover, the new guidelines have shed light on the limitations of the present evidence for treatment of blood pressure conditions, while providing reasonable suggestions based on the same.