New Blood Pressure Treatment Guidelines
Written by Editor   
Friday, November 24, 2017 09:07 AM

New blood pressure guidelines have been issued by the American College of Cardiology and the American Heart Association.   In a 192 page document FOUND HERE.

Various studies indicate chiropractic care can be an effective nonpharmacological therapy for hypertension (see sources below).

The new guidelines have two stages of hypertension and a new name for prehypertension. The new guidelines call for blood pressure readings of less than 120/80 to be considered normal. Pressure readings of 120-129/less-than-80 (between 120/79 to 129/79) are now considered elevated.  Hypertension, Stage 1 now is considered to begin at reading of between 130-139/80-90.  Stage 2 hypertension occurs at readings of greater than 140/90, and a “hypertensive crisis” is considered to occur at readings of greater than 180/120.

Blood pressure readings should be based on and average of two or more careful readings on two or more separate occasions.  Adults already being treated with hypertensive medication are automatically designated as hypertensive.

Systolic

 

Diastolic

Previously

2017

<120

AND

<80

Normal

Normal BP

120-129

AND

<80

Prehypertension

Elevated BP

130-139

OR

80-89

Prehypertension

Stage 1 Hypertension

140-159

OR

90-99

Stage 1 Hypertension

Stage 2 Hypertension

≥160

OR

≥100

Stage 2 Hypertension

Stage 2 Hypertension

≥180

OR

≥120

Stage 2 Hypertension

Hypertensive crisis

 

The new guidelines leave hypertensive medication to the stage 1 and stage 2 levels of hypertension and recommends lifestyle and non-pharmacological interventions for all.  

BP thresholds and recommendations for treatment

  • Normal BP: Promote optimal lifestyle habits
  • Elevated BP: Non-Pharmacological therapy 
  • Stage 1 Hypertension with Clinical cardiovascular disease or risk of atherosclerotic cardiovascular disease greater-than or equal to 10%:
    • Yes: non-pharmacological therapy and BP lowering medication
    • No: non-pharmacological therapy
  • Stage 2 Hypertension:  non-pharmacological therapy and BP lowering medication

The new guide lines lower the level at which hypertension is diagnosed and will increase its prevalence, it is not anticipated that the change will have a large an impact on the prevalence of antihypertensive treatment due to risk-based recommendations in stage 1 hypertension.

The recommendations for non pharmacological interventions include:

  • Weight loss is recommended to reduce in BP in adults with elevated BP or hypertension in patients who are overweight or obese.

  • A heart-healthy diet, such as the DASH (Dietary Approaches to Stop Hypertension) diet, that facilitates achieving a desirable weight is recommended for adults with elevated BP or hypertension.

  • Sodium reduction is recommended for adults with elevated BP or hypertension.

  • Potassium supplementation, preferably in dietary modification, is recommended for adults with elevated BP or hypertension, unless contraindicated by the presence of CKD or use of drugs that reduce potassium excretion.

  • Increased physical activity with a structured exercise program is recommended for adults with elevated BP or hypertension.

  • Adult men and women with elevated BP or hypertension who currently consume alcohol should be advised to drink no more than 2  for elevated BP and 1 standard drinks per day for hypertension.