*In 2017, the American Heart Association and other health organizations revised the definition of high blood pressure, lowering the threshold to 130/80 mm Hg for all adults.
Harvard Health reports that hypertension was previosuly defined as 140/90 mm Hg for those under 65 and 150/80 mm Hg for those 65 and older. This change aims to encourage earlier intervention to prevent related issues like heart attacks and strokes. The update was informed by the Systolic Blood Pressure Intervention Trial (SPRINT), which revealed that targeting a systolic pressure of 120 mm Hg or lower significantly reduced cardiovascular risks over three years among adults aged 50 and above with high blood pressure and at least one cardiovascular risk factor.
The updated guidelines eliminated the “prehypertension” category, which previously included people with a systolic reading of 120–139 mm Hg or a diastolic reading of 80–89 mm Hg. Now, individuals with a systolic reading of 120–129 mm Hg are classified as having elevated blood pressure, while those with readings of 130–139/80–89 mm Hg are categorized as Stage 1 hypertension. Stage 2 hypertension starts at 140/90 mm Hg, and anything above 180/120 mm Hg is considered a hypertensive crisis.
For those previously diagnosed with high blood pressure, the changes won’t impact management significantly, though doctors may now recommend a lower blood pressure target. Individuals aged 65 and older may now fall under the high blood pressure category. Medication isn’t always the first line of action. Instead, lifestyle adjustments—like adopting the DASH or Mediterranean diet, increasing physical activity, and weight management—are recommended initially. Medication is suggested only if the individual has a history of heart attack or stroke, or if they face a high 10-year cardiovascular risk.
Overall, the guideline adjustments aim to promote more proactive monitoring and management of blood pressure.
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