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The National
Heart, Lung and Blood Institute (NHLBI) has released new clinical
practice guidelines that recognize that damage to the arteries
begins at lower blood pressure levels than previously considered
optimal.
The guidelines
are part of the Seventh Report of the Joint National Committee
on Prevention, Detection, Evaluation, and Treatment of High
Blood Pressure and represent an update from the previous ones
issued in November 1997.
"The
bottom line is that Americans must change how they think about
blood pressure," said Dr. Ed Roccella, coordinator of
NHLBI's National High Blood Pressure Education Program. "The
sooner they take action, the better. It's vital that they
adopt a heart-healthy lifestyle early, even if their blood
pressure is normal."
The guidelines
recognize that the risk of death from heart disease and stroke
begins to increase even at blood pressures as low as 115 over
75 mmHg and that it doubles for each 20 over 10 mmHg increase
beyond that mark. Previously, the normal or optimal mark was
120/80 mmHg.
The new
guidelines consider normal blood pressure to be less than
120/80 mmHg. The new level of prehypertension includes a blood
pressure range of 120-139/80-89 mmHg. Stage 1 hypertension
is considered to be between 140-159/90-99 mmHg, while stage
2 hypertension is at or greater than 160/at or greater than
100 mmHg.
The guidelines
do not recommend drug therapy for those with prehypertension
unless it is required by another condition, such as diabetes
or chronic kidney disease. But the report advises them as
well as those with normal blood pressures to make any needed
lifestyle changes.
Such changes
include losing excess weight, exercising, limiting alcoholic
beverages and following a heart-healthy eating plan, including
cutting back on salt and other forms of sodium. The report
also recommends that people quit smoking.
Source:
Hypertension
Week of May 18, 2003
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