Understanding new blood pressure guidelines

Understanding new blood pressure guidelines

In 2017 the American Heart Association (AHA) and American College of Cardiology (ACC) released new guidelines for the diagnosis and management of high blood pressure in adults. Among the changes include stricter blood pressure goals and slightly different terminology.

Gone is the term “prehypertension,” replaced with “elevated blood pressure,” for those patients not yet meeting the criteria to be labeled as hypertensive. The new guidelines state that a normal blood pressure for adults should be less than 120/80. This is relevant because a significant number of people now find themselves with a brand new medical diagnosis.

Blood pressure guidelines for children

The same is true for children. Last year, the American Academy of Pediatrics (AAP) released its own set of new blood pressure recommendations—the first update since 2004. The terminology is similar to that of the adult guidelines, but of course, the blood pressure goals are different.

Blood pressure criteria for children vary with the age and height of the patient, meaning a universal cutoff of 120/80 is not appropriate. Generally, the younger the patient the lower the blood pressure should be. The new guidelines provide physicians with normative blood pressure tables for each age and algorithms for diagnosis and treatments.

For patients older than 13 years and older, the blood pressure goals align with the AHA/ACC recommendations for adults. Infants and children are more likely to have what is known as secondary hypertension, meaning elevated blood pressure may be a sign of some other medical issue.  Therefore, additional testing is usually indicated for pediatric patients with high blood pressure.

Self-monitoring

The guidelines for both adults and children emphasize additional blood pressure monitoring at home.

Obtaining blood pressure measurements in a variety of settings throughout the day can more accurately reflect one’s “true” blood pressure trends. This may help to reduce inappropriate diagnosis of hypertension for those who are merely anxious at the doctor’s office.

It is important to understand that while many patients will now be advised to take medication to control their blood pressure, it will not always be necessary. For adults and children alike, the initial treatment recommendation in many cases will be diet/lifestyle changes and weight loss. Losing weight and maintaining a healthy diet are powerful ways to improve your blood pressure and reduce the risk of developing cardiovascular disease, among many other health benefits.

Both the AHA/ACC and AAP guidelines were based upon solid medical evidence. They were developed by experts in the field after review of thousands of medical studies. Achieving your blood pressure goal can be frustrating but is certainly well worth the effort in the long run. If you have questions, I encourage you to bring them to your family physician or pediatrician at your next visit.

This article originally appeared in the January 28, 2018, edition of The Herald-Dispatch.

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Jeffrey K. Harris, MD

Dr. Harris is a board-certified, fellowship trained pediatric cardiologist with Marshall Health and an assistant professor at the Marshall University Joan C. Edwards School of Medicine.