Conservative Guidelines for High Blood Pressure Will Help You Manage Better Health as You Get Older

Updated guidelines encourage individuals and physicians to be more proactive when dealing with high blood pressure—the goal is to reduce risks of heart attack, stroke, long-term care, and premature death. Don't ignore blood pressure, especially in your 50s when it often first develops.
Updated: February 9th, 2022
Linda Kople

Contributor

Linda Kople

There are now updated parameters for high blood pressure as doctors have become more conservative with the 'silent killer - high blood pressure.

In 2017, several institutions, including the American Heart Association, the American College of Cardiology, and nine other health organizations, lowered the numbers for diagnosing high blood pressure. 

What was once normal blood pressure may now be considered high and should be treated with medication. The old guidelines said any blood pressure of 140 over 90 or higher would be regarded as high blood pressure. Under the new guideline, both men and women should be treated if their blood pressure is 130 over 80 or higher.

Nearly half of all adult Americans will be considered to have high blood pressure under new guidelines issued by the nation's top heart health organizations.

"Reducing the blood pressure under 130 over 80, lower than what we thought before, prevents more heart attacks, prevents more strokes, and prevents death and so that's why the guidelines have changed," says Dr. Haitham Ahmed, Preventative Cardiologist at the Cleveland Clinic.

According to the report, the new guidelines will classify 103.3 million people as having high blood pressure, while the previous guidelines placed only 72.2 million Americans in this category.

46% Now Considered Having High Blood Pressure

Dr. Paul Whelton, chair of the 2017 Hypertension Practice Guidelines and a professor of Global Public Health at Tulane University School of Public Health and Tropical Medicine in New Orleans, says 46% of the US adult population will be considered to have high blood pressure. 

"The latest medical evidence has proven that people with blood pressure in the 130-139 range carry a doubled risk of heart attack, stroke, heart failure, and kidney failure, compared to those with lower blood pressure", said Dr. Joaquin Cigarroa, a member of the clinical guidelines task force.

Previously, those people were considered to have prehypertension, but not actual high blood pressure.

Blood pressure categories in the new guidelines are:

  • Normal: Less than 120 systolic pressure (the top number).
  • Prehypertension: 120 to 129.
  • Stage 1: Systolic between 130 and139.
  • Stage 2: Systolic of 140 or higher.

Systolic pressure is the amount of pressure in your arteries during the heart muscle contraction.

Treatment Now More Aggressive

"By being more aggressive when people are younger, we hope to prevent bad outcomes later," Dr. Siddharth Gandhi of Advocate Heart Institute at Advocate BroMenn Medical Center in Normal, Illinois.

The goal of the guideline is to reduce the risk of heart attack and stroke. Strokes are also a significant cause of long-term care in addition to death.

"What we now know, from several clinical trials involving more than 140,000 patients, that if we get that blood pressure down even lower, less than 130 over 80, maybe even down to the 120s over 70's – then you can reduce risk of heart attack, reduce risk of stroke and increase their longevity," said Dr. Ahmed.

For most people, Dr. Ahmed said the first step towards lowering blood pressure involves lifestyle modifications, such as reducing sodium intake, losing weight, exercising more, reducing alcohol intake, and eating a diet that is high in fiber and lower in fat.

Being Prepared

When we get older, we experience many changes in our health. High blood pressure can be the start of an overall health decline that starts in our 50s. The decline leads to illnesses, many of which can lead to significant health issues leading to long-term care and even premature death.

Being proactive with our health and planning can help us prepare for the costs and burdens of getting older. Long-term care has become a substantial risk leading to in-home care or institutional care in a long-term care facility. 

Health insurance, including Medicare (and supplements), will not pay for most of this care, leading to tremendous risk to savings and creating a burden to family caregivers who often must step in and provide care. 

Going to the doctor for regular check-ups, a better diet, exercise, and good planning will help manage these risks. Part of the plan should include Long-Term Care Insurance, which will provide you with the resources for quality care options. When you have a policy, you own a solution that will reduce the stress on loved ones and protect income and assets.

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