Tension Rises Over New Terms For Old Problem

By Carlos Rubio-Reyes, MD, BScPhm

New guidelines have recently been released that may change the management of hypertension, otherwise known as high blood pressure.

In November 2017, the American College of Cardiology/American Heart Association (ACC/AHA) proposed a new, lower threshold for the diagnosis of hypertension: a systolic blood pressure of over 130 mmHg (instead of 140) or a diastolic blood pressure of over 80 mmHg (instead of 90).

It is estimated that under these newly recommended guidelines, approximately half of the US population will be diagnosed with high blood pressure. Under the previous definition, an estimated one-third of Americans would be diagnosed with high blood pressure.

In December 2017, the American Academy of Family Physicians (AAFP) released a statement that disavowed these new guidelines, opting rather to continue to endorse the 2014 guideline by the Eighth Joint National Committee (JNC8). The AAFP went on to say that they “felt strongly that the JNC8 upheld the scientific rigor that provided strong recommendations to family physicians and patients on appropriate treatment of hypertension.”

Despite the controversy, what continues to be agreed upon is the danger high blood pressure poses to the individual: increasing the risk of heart disease and cardiovascular-related mortality, as well as stroke and kidney disease.

For any patients who have high blood pressure, I recommend the following lifestyle changes:

· Weight loss through diet and exercise. There is typically a measurable improvement in blood pressure for every pound lost.

· Limited alcohol intake

If you have high blood pressure, it is important to see your physician regularly.

Carlos Rubio-Reyes, MD, BScPhm, is a board-certified physician who specializes in family medicine. He practices at Boone Medical Group – North in Columbia, Mo.