Is Your Blood Pressure Too High?

A year ago, for many, the answer to this question would have been no. However with the release of the “7th Report of the Joint National Commission on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure,” the criteria has changed on how doctors look at blood pressure. What was once “okay” or “borderline” can actually now be considered a warning sign for heart disease.

Most people are familiar with the textbook “120/80” reading signifying a normal blood pressure. These numbers refer to the systolic pressure (the pressure when the heart muscle contracts) or 120 millimeters of mercury (the “yardstick” for pressure) over a diastolic pressure (the pressure of the blood vessels when the heart muscle relaxes and fills the heart with blood) of 80 millimeters of mercury. Much of the population is close to this with readings from 120-135 over 80-85, which according to previous guidelines was acceptable.

Now a new category of “pre-hypertension” has been created to address the growing evidence that the higher the blood pressure gets from the new “normal” set point of 115/75, the higher the risk for heart attack, heart failure, stroke, or kidney disease. People with blood pressures in the 120-139 systolic or 80-89 diastolic ranges are now candidates for aggressive lifestyle modification including weight loss, exercise, alcohol reduction, and smoking cessation.

Beyond pre-hypertension, there are the far more serious conditions of hypertension: Stage 1 (140-159 / over 90-99) and Stage 2 (160 or greater / over 100 or greater). These conditions require a daily medication or, in some cases, a combination of medications. For every 20 points systolic over 10 points diastolic, the risk for cardiovascular diseases described above goes up two-fold. Therefore, if your blood pressure is 135/85 you are twice as likely to have disease; if it is 155/95 you are four times more likely to have problems. If you have diabetes or kidney disease, the tolerable blood pressure level goes down to below 130/80.

While some people have a condition that causes their blood pressure to be elevated, other have hypertension that can be reversed with lifestyle changes. Getting aerobic exercise for 20-30 minutes a day, cutting down on things that elevate blood pressure such as caffeine, alcohol, or salt, and eliminating nicotine and tobacco products can have a very positive effect on controlling pressure. Sometimes losing even small amounts of weight, such as five or ten pounds, can lower blood pressure readings.

Since studies have revealed that the average 55 year old with normal blood pressure will have a 90% risk of developing high blood pressure in his or her normal lifetime, it has become more important than ever to closely monitor blood pressure and treat it in a timely manner. Getting checked at least once a year at an annual physical and discussing healthy lifestyle habits with your doctor could make a big difference in preventing the detrimental outcomes of cardiovascular disease.