New Blood Pressure Guidelines: What Every Adult Should Know About Hypertension Treatment
New recommendations from the American Heart Association emphasize earlier intervention, lifestyle changes, and more aggressive blood pressure control to help reduce the risk of heart disease, stroke, dementia, and kidney disease.
By Kim Hagen, PA-C, Hypertension Specialist, Virtua Cardiology
Strapping on a blood pressure cuff remains a key part of routine health care. But what happens after it comes off could change the next time you visit your health care professional. That’s because the American Heart Association and the American College of Cardiology recently issued new high blood pressure guidelines for the first time since 2017.
Let’s look at what’s different—and what it means for you.
What are the stages of high blood pressure?
The categories of blood pressure remain the same:
- Normal: less than 120/80 mmHg
- Elevated: 120-129 / less than 80
- Stage 1 hypertension: 130-139 or 80-89
- Stage 2 hypertension: 140 or higher or 90 or higher
- Severe hypertension (no symptoms): Higher than 180 and/or higher than 120
- Hypertensive emergency (with symptoms): Higher than 180 and/or higher than 120
When and how should high blood pressure be treated?
What’s new is when your provider may recommend treatment. The new guidelines outline that the closer we can get patients to a normal blood pressure, the better:
- If you have an elevated blood pressure or stage 1 hypertension, we start with a focus on lifestyle interventions such as the DASH diet, increasing dietary potassium, and getting 150 minutes of exercise per week, including aerobic and resistance training.
- If you remain hypertensive despite their best efforts after three months, we initiate therapy to support getting you to goal.
- If you have a systolic blood pressure greater than 140, medications are offered sooner because we know that it improves outcomes.
As high blood pressure also contributes to the development of dementia, the guidelines recommend intensive treatment to lower it.
What do the hypertension guidelines say about medication?
The new guidelines provide uniform treatment recommendations for all patients, regardless of race. Calcium channel blockers, thiazide diuretics, angiotensin-converting enzyme (ACE) inhibitors, and angiotensin II receptor blockers (ARBs) are mainstream therapies for everyone.
They also recommend the greater use of combination medications to decrease the burden of people taking too many pills, as well as GLP-1 drugs for those who are overweight and have high blood pressure.
Does alcohol raise blood pressure?
Speaking of lifestyle habits, drinking even small amounts of alcohol can raise blood pressure over time. That’s why the new guidelines say the ideal choice is to avoid it altogether.
How is high blood pressure managed during and after pregnancy?
High blood pressure during and after pregnancy can lead to complications like preeclampsia, stroke, kidney problems, and preterm birth. Women with a blood pressure of 140/90 mmHg or higher during pregnancy should be treated with medication and closely monitored after delivery.
The early diagnosis and treatment of hypertension is proven to improve your overall health. If your blood pressure is resistant to treatment, our hypertension clinic will identify the causes of your condition and ensure you receive the most optimal treatments.
Virtua will help manage your blood pressure.
Virtua's hypertension specialists help patients across South Jersey manage difficult-to-control blood pressure through personalized treatment plans, lifestyle counseling, and advanced diagnostic evaluation. Call 888-847-8823 to make an appointment with a Virtua cardiologist near you.
There's So Much More to Explore
