New guidelines to alter management of high blood pressure

Published 4:17 pm Monday, January 1, 2018


Hypertension is a condition where the force of blood on the walls of your arteries is too high. Also known as high blood pressure, hypertension is a major risk factor for developing cardiovascular disease, which is the number one cause of death in our country. A recent change to hypertension guidelines will affect how high blood pressure is diagnosed and managed, and it may affect you.

In the new 2017 Guideline for the Prevention, Treatment, Evaluation and Management of High Blood Pressure in Adults, the American College of Cardiology and American Heart Association issued new statements that define hypertension as blood pressure greater than 130/80 mm Hg. This is significantly lower than previous guidelines that considered a blood pressure of 140/90 mm Hg or greater to be classified as hypertensive. According to a recent article from the ACC/AHA, these new guidelines affect some 31 million Americans who will now require treatment for hypertension. The exact impact these guidelines will have on the systemic management of hypertension is yet to be determined, but an emphasis should be placed on promotion of non-pharmacological treatment methods.

Of the 31 million Americans newly classified as hypertensive, the ACC and AHA estimate 4.2 million will require medication. This means close to 27 million newly diagnosed hypertensive individuals will be steered to alternative treatments such as weight loss, dietary changes, exercise, stress management and reduced sodium intake. Patients already taking antihypertensive medication may also see changes to their existing treatment plan. Intensified dosages or the addition of one or more antihypertensive medications may be considered to further lower blood pressure for these patients. Of course, increases in medication are accompanied by an increased likelihood of developing negative side effects. To diminish the need for increases in medication, all individuals should consider the aforementioned non-pharmacological treatments.

Physical activity, according to the new report, was ranked among the best non-pharmacological interventions for treatment of hypertension. A 2013 meta-analyses published in the Journal of the American Heart Association showed endurance training can lower systolic blood pressure by 8 mm Hg and diastolic blood pressure by 5 mm Hg in hypertensive individuals. Systolic blood pressure is the number listed first when reporting blood pressure and represents the pressure on your arteries when your heart is squeezing. Diastolic blood pressure is the second number listed (SBP/DBP) and it represents the pressure on your arteries when your heart is resting between beats. The great news is these reductions in pressure can be seen after a single bout of exercise and last up to 24 hours after the session concludes. Participating in 30 minutes of daily exercise may be enough to reduce or even eliminate the need for medication.

Physical activity paired with lifestyle changes in nutrition, stress levels and weight management will aid in the battle against hypertension. Adopting the DASH (Dietary Approaches to Stop Hypertension) diet plan can help lower sodium intake below the FDA’s recommended maximum of 2,300 mg per day, and it does so by increasing intake of potassium, calcium, fruits, vegetables and low-fat dairy while reducing intake of dietary cholesterol, total and saturated fats. While we cannot control our family history, sex, race or age and their effects on our susceptibility to developing high blood pressure, we all have the power to choose a healthier lifestyle.

Travis Rogerson is a clinical exercise physiologist at the Vidant Wellness Center – Washington and can be reached at 252-975-4236.