NORMAL — Lowering the threshold for high blood pressure means more people will be diagnosed and treated, but the result should be fewer people having heart disease and strokes down the road, concludes a Bloomington-Normal cardiologist.
"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 said Monday.
"A lot more people are going to be diagnosed with hypertension (high blood pressure), but the result will be fewer cardiovascular events down the road," Gandhi said.
The American Heart Association and the American College of Cardiology published on Monday new guidelines defining high blood pressure as 130 over 80 rather than 140 over 90. Normal blood pressure is considered to be 120 over 80.
The guidelines were presented at the heart association's annual Scientific Sessions in Anaheim, Calif.
Gandhi described the new guidelines as "sound" and "a long time coming."
High blood pressure is the No. 2 cause of preventable heart disease and stroke behind smoking, Gandhi said. High blood pressure sometimes is called the silent killer because it contributes to cardiovascular disease with no symptoms.
The challenge with the previous guideline is a patient with a reading of 135 over 85 may not have been treated for high blood pressure, Gandhi said. Five years later, when that patient has a reading of 140 over 90 and is overweight, he or she is at significantly greater risk of cardiovascular disease so they are immediately placed on blood pressure medicine and counseled on exercise and healthy eating.
With the new guidelines, that patient will be "read the riot act" about exercise and healthy eating but the goal will be for them to bring their blood pressure down with those lifestyle changes before prescribing medications, Gandhi said.
Thirty-two percent of American adults have high blood pressure under the previous guidelines and that will increase to 46 percent under the new guidelines, the heart association said. But only a small percentage of those patients will be prescribed anti-hypertensive medication, the association said.
Gandhi recommends that people who are at risk of high blood pressure buy a quality blood pressure cuff that wraps around their arms and to become comfortable taking their own blood pressure readings from time to time and reporting them to their doctor. Then a person's reading becomes the average of those numbers and reduces the risk of "white coat hypertension" — blood pressure readings that are improperly elevated because a patient in a doctor's office is nervous.
In addition to knowing their numbers, everyone should reduce their risk of high blood pressure by engaging in 30 minutes of cardiovascular exercise and 30 minutes of weight lifting five days a week and eating a healthful diet that includes fresh vegetables and fruits, lentils and less than 1,500 milligrams of sodium each day, Gandhi said.