Under New Guidelines, Millions More Americans Will Need to Lower Blood Pressure

If Americans act on the guidelines and lower their blood pressure by exercising more and eating a healthier diet, or with drug therapy, they could drive an already falling death rate from heart attacks and stroke even lower, experts said.

Now, high blood pressure will be defined as 130/80 millimeters of mercury or greater for anyone with a significant risk of heart attack or stroke. The previous guidelines defined high blood pressure as 140/90. (The first number describes the pressure on blood vessels when the heart contracts, and the second refers to the pressure as the heart relaxes between beats.)

Cardiovascular disease remains the leading cause of death among Americans. The new criteria, the first official diagnostic revision since 2003, result from growing evidence that blood pressure far lower than had been considered normal greatly reduces the chances of heart attack and stroke, as well as the overall risk of death.

Recent research indicates this is true even among older people for whom intensive treatment had been thought too risky. That finding, from a large federal study in 2015, caught many experts by surprise and set the stage for the new revision.

That calculation must be individualized, and experts are recommending that patients use a calculator developed by the guidelines committee at ccccalculator.ccctracker.com.

Nearly half of all American adults, and nearly 80 percent of those aged 65 and older, will find that they qualify and will need to take steps to reduce their blood pressure.

Even under the relatively more lenient standard that had prevailed for years, close to half of patients did not manage to get their blood pressure down to normal.

“Is it going to affect a lot of people, and is it going to be hard to meet those blood pressure goals?” asked Dr. Raymond Townsend, director of the hypertension program at Penn Medicine. “The answer is a pretty significant yes.”

According to the new…

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