Imagine being given a clean bill of health at your routine physical examination, only to find out the next day that you have a dangerous long-term medical condition. This reality is currently hitting millions of Americans, as new guidelines on hypertension indicate that the disease now affects nearly half of American adults, many of whom were previously considered healthy.

History of Hypertension

Since the 19th century, numerous physicians, including Thomas Young, Richard Bright, and Frederick Akbar Mahomed, have studied the medical condition known as hypertension. Commonly known as high blood pressure, hypertension came into prominence within the medical community in 1896 when Scipione Riva-Rocci invented the cuff-based sphygmomanometer, allowing blood pressure to be quantified. By the mid-twentieth century, measuring patients’ blood pressure using the sphygmomanometer became standard practice for physicians during physical examinations. However, during this period, hypertension was not widely considered a serious disease, illustrated by Franklin D. Roosevelt’s physician deeming him to be healthy despite the President’s severely high blood pressure. Today, healthcare providers pay far more attention to patients’ blood pressure, as hypertension has become increasingly prevalent.

The primary goal of the new guidelines is to promote early recognition of the problem and healthy changes in lifestyle.

Dangers of Hypertension

Hypertension is a medical condition in which arterial blood pressure, or the force of blood pushing against vessel walls, is consistently high. The increased pressure in the arteries overworks the heart, and can lead to long term tissue damage in the arteries. If not addressed, long-term high blood pressure can lead to stroke, heart failure, and coronary heart disease, among other health issues. In fact, hypertension is known as the “silent killer,” as it often does not have any clear symptoms, but is nonetheless incredibly dangerous. It is second to smoking in causing stroke and heart disease related deaths.

The New Guidelines

The comprehensive new guidelines, designed to “address the prevention, detection, evaluation, and management of high blood pressure in adults,” were outlined by the American Heart Association (AHA) and the American College of Cardiology (ACC). The guidelines are the culmination of almost three years of clinical trials and studies, and are the first guidelines to be released since 2003. The central focus is an emphasis on the importance of doctors and patients knowing how to properly measure blood pressure and diagnose hypertension.

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Known as the “silent killer,” hypertension is associated with numerous life-threatening health complications.

Photo by: Wikimedia Commons

According to the AHA and ACC’s new guidelines, hypertension should now be treated at 130/80 mmHg, as opposed to the previously recommended measure, 140/90 mmHg. 130/80 mmHg is the new measure for Stage 1 hypertension, and 140/90 mmHg is now considered to be Stage 2 hypertension. Normal blood pressure is anything less than 120/80 mmHg. By contrast, hypertensive crisis occurs with a blood pressure exceeding 180/120 mmHg. Patients with hypertensive crises are likely to need changes in medication or immediate hospitalization if organ damage occurs.

The AHA and ACC stress the importance of making healthier choices earlier on in life, such as incorporating a heart-healthy diet with reduced salt and foods high in potassium, including bananas, potatoes, avocados, and dark leafy greens. Additionally, the guidelines recommend increased exercise, no smoking, and reduced alcohol consumption.

What Do These Guidelines Mean?

The new guidelines released by American Heart Association indicate that the issue of hypertension is even more pressing than previously thought, as nFearly half the U.S. adult population is now considered to have high blood pressure. Under the previous guidelines, thirty-two percent Americans adults were diagnosed with hypertension; however, with the new cutoff of 130/80 mmHg, that number has risen to forty-six percent.

Certain groups will be particularly affected by the new guidelines. Between the ages of 20 and 44, hypertension rates will nearly triple among men and double among women. Around 75% of men in the age range of 55 to 74 will likely now be diagnosed with high blood pressure. Additionally, hypertension rates in Asian men will increase by 16%, and rates in Black and Hispanic men will increase by 17%.

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The relative increases in number of hypertension diagnoses in men and women from the previous guidelines (seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: JNC 7, in gray) to the current guidelines (Hypertension Clinical Practice Guidelines: 2017 HPCG, in red). Women diagnosed will increase by thirteen million, while men will increase by eighteen million.

Graphic by: AHA Center for Health Metrics and Evaluation

Despite the increase in amount of people who will now be diagnosed with hypertension, the new guidelines will supposedly not lead to a significant increase in the number of people requiring medication. Paul Whelton, M.D., chair of the guideline writing committee, estimates that, of the new adults who fall into the high blood pressure range, only 1 in 5 will need medication.

Looking Ahead

The fact that nearly half of the American adult population can now be diagnosed with a condition known to have potentially deadly consequences is a clear source for concern. However, the primary goal of the new guidelines is to promote early recognition of the problem and healthy changes in lifestyle. Simple ways to reduce hypertension include exercising regularly, eating a balanced diet, reducing sodium intake, and limiting alcohol consumption. Thus, these updated standards are perhaps not a source for panic, but rather a necessary wake-up call for millions of Americans.

About The Author

Aishwarya Kalyanaraman