What Do the New Blood Pressure Guidelines Mean?

Why are the new blood pressure guidelines causing such a stir? Because they place 46% of Americans in the high blood pressure range. Lets look at what blood pressure is, how it is measured, what these new guidelines are & how we can bring our blood pressure down naturally. 

As your heart beats, it pushes the blood through your circulatory system to bring your body the oxygen it needs. As it moves through the blood vessels it exerts pressure on them. Blood pressure is measured on the arterial system. There are 2 numbers, for example, 120/76. The top number, systolic, is the pressure on the arterial wall as your heart beats. The bottom number, diastolic, is the pressure of the resting of the heart between beats. 

Here are some tips on how to make sure you get a correct reading when either you are taking it at home or having it taken in a medical setting.

  • Take your blood pressure at the same time every day. It is highest in the early morning, so choose a later time.
  • Make sure you are using the correct cuff size. This will effect the reading. There are cuffs for children, adults of normal weight & a cuff for larger arms.
  • Don’t eat or drink caffeine at least 30 minutes before a reading. And don’t smoke at least 30 minutes before a reading.
  • Empty your bladder 🙂
  • Take time to sit quietly for about 5 minutes before the reading. I know that in a medical setting it is usually rushed.
  • Make sure that the cuff is on bare skin. Don’t roll up a tight sleeve above the cuff. Wear something loose or if at home take off the shirt.
  • Sit with your back straight, with feet flat on the floor. DO NOT cross your legs.
  • Place your cuffed arm on a table at heart level with the other palm resting on your leg.
  • No talking during the reading!
  • If you or your medical team is not satisfied with the first reading then have it taken again after waiting for 5 minutes. It should not be taken immediately after the first reading. Some authorities recommend that you take it 3 times with a 5 minute break between times & average the last 2 reading for an accurate test.

What has been considered normal, high & low blood pressure has changed over the years due to new research & understanding of heart disease. Back in the 60’s I remember being told as a young nurse that you would take your age & add 100 & that would be your normal for the systolic. Once you aged past 60 years old you would use 160 as normal.

Take a look at this paper from the Journal of Clinical Hypertension: Historical Perspectives on the Management of Hypertension by Marvin Moser, MD The author uses the health of President Franklin D. Roosevelt in the 1940’s as an example of what was considered normal treatment. In the 1948 textbook, Cardiology, your blood pressure was high if over 180/110. This was based on the medical evidence at that time. In the 1950’s older patients were not treated when their blood pressure was between 160/80 – 200/110! He continues thru the years to show what was considered high & how it was treated. Good article.

 My summary of the new changes are as follows: 

  • Normal is now below 120/80. It was 140/90.
  • Elevated blood pressure is 120-129 systolic & a diastolic less than 80. This is a reading that is not considered hypertension.
  • A diagnosis of hypertension is called Stage 1: 130 – 139 systolic & 80-89 diastolic.
  • Stage 2 hypertension: above 140/90

The new guidelines include these lifestyle changes for all patients. These are recommended particularly for those with “elevated” blood pressure readings rather than medication.

  • Weight loss for overweight or obese people
  • Heart healthy diet like DASH
  • Salt restrictions
  • Increase potassium intake through diet..DASH diet is naturally high in potassium.
  • A diet low in sodium, saturated fat, and total fat with an increase in fruits, vegetables, and grains has the biggest impact in lowering the blood pressure 🙂
  • Exercise & a general increase of physical activity during your day.
  • Alcohol: Men no more than 2 servings per day & women no more than 1 per day. 

A plus for these guidelines is that they include recommendations for race, gender & age. Takes the guesswork out of what your normal should be. They also give the doctor better guidelines for what treatment a patient should receive & when to recommend lifestyle changes. These recommendations will now be at an earlier age which is why most doctors like these new guidelines. Catch potential heart disease earlier.

Harvard Health Publishing: New high blood pressure guidelines: Think your blood pressure is fine? Think again…,   NOVEMBER 17, 2017, by Monique Tello, MD, MPH, Contributing Editor  Good explanation of the guidelines. 

Nearly half of Americans now have high blood pressure, based on new guidelines  By Susan Scutti, CNN, November 14, 2017 This article is quite good. It explains the shortcomings of the new guidelines & what the physicians are worried about. 

From what I have read in several articles, the main concern is that many more people will be put on medications that in some physicians eyes are not needed. After looking over the guidelines I think they will cause physicians to evaluate patients more intently when it comes to earlier detection of heart disease. 

In the guidelines, adults 60 years or older will be diagnosed with hypertension if over 150/90 & medications will be given. Concern about raising this limit for older adults has been expressed because it is felt that this will increase heart disease in this age group if not medicated earlier. Proponents of this change state that these new numbers are based on the most up to date scientific information & research on this age group.

Lifestyle changes to lower blood pressure are not that different than the lifestyle changes to lower cancer risk. Relaxation techniques to decrease stress along with exercise can reduce your blood pressure effectively. Diet is extremely important. Just losing 10% of your current weight, if overweight or obese, will bring about significant changes in your blood pressure.

I am not going to list the foods you should & shouldn’t be eating, you should know that by heart from previous posts. Think DASH, MIND & Mediterranean diets 🙂 But I will point you in the right direction. 

If you want a scientific view of the DASH, Dietary Approaches to Stop Hypertension, diet & its effects on blood pressure, read this abstract from the Journal of the American College of Cardiology: Effects of Sodium Reduction and the DASH Diet in Relation to Baseline Blood Pressure

From Spectator Health: Low-salt diet ‘as effective as drugs’ for hypertension  Very good article about research with a low salt DASH diet & its effects on blood pressure. The bottom line is that it performed better than prescription drugs. Check out my post in 2015 on the DASH diet or from the NIH: Description of the DASH Eating Plan

High blood pressure: Could diet replace medication?  By November 24, 2017  Another good article about research on the low salt-DASH diet. 

One thing to remember is that the body does need sodium, salt, to function. So if you are going to limit your salt intake, use the recommendations given with the DASH diet. Too little salt can have the opposite effect by raising the risk of heart disease & stroke. It is all about BALANCE. Remove the salt shaker from the table & replace it with flavorful herbs. ***Braggs Organic Sprinkles: 24 Herbs & Spices  My favorite! 

This is not really off topic 🙂 I wanted to share this article that I came across. 17 tips to pick the freshest veggies and ripest fruit, Nov. 17, 2017, TODAY  Goes along with a healthy low-salt diet!

Until next week…Mary 🙂