What Is Considered High Blood Pressure?
New treatment guidelines intended to help people avoid heart attacks and strokes have been released. This latest advice on lowering blood pressure from the American College of Physicians (ACP) and the American Academy of Family Physicians (AAFP) may help you stay healthy.
For many doctors and consumers, uncertainty arose after the 2015 release of results from a large clinical trial called Sprint. Researchers advised that people with high blood pressure aim for a systolic (upper number) of less than 120 mm/Hg. That’s well below what’s recommended by many expert groups and the government.
But Sprint involved people at high risk for cardiovascular disease, so its findings—and its advice on blood pressure levels—didn’t necessarily apply to those at lower risk. And getting blood pressure below 120 (as the Sprint researchers suggested) usually requires a high dose of medication or the use of multiple medications. Both significantly increase the likelihood of serious side effects, such as fainting from severely low blood pressure, or kidney failure.
New Clarity on Blood Pressure Levels
Enter the new advice from ACP and AAFP. If you're 60 or older and have no other cardiovascular risk factors (diabetes, high cholesterol, a smoking habit), these guidelines recommend maintaining a systolic reading below 150 mm/Hg.
That’s appropriate for most people in the group above, researchers say. Here’s why: The two dozen studies reviewed for the guidelines suggested that aggressive treatment to get systolic blood pressure below 140 in people who are over age 60 didn’t extend life or reduce the number of heart attacks. It did, however, possibly lower the risk of strokes.
The new guidelines also recommend that people over age 60 at high risk for cardiovascular problems or who had a heart attack or stroke consider treatment with medication when their systolic level reaches 140. The goal for these people is a systolic level below 140.
But the new guidelines leave it up to you and your doctor to determine exactly what blood pressure level is best. That’s because some people may be able to better tolerate the side effects that can occur with aggressive medication therapy to lower blood pressure.
If you're under age 60, the ACP/AAFP guidelines don't include recommendations for you. You can follow these 2014 guidelines from the expert group known as the Eighth Joint National Committee as well as advice from the medical experts at Consumer Reports and Consumer Reports Best Buy Drugs: You’re considered to have high blood pressure if your systolic reaches 140 or your diastolic—the bottom number—reaches 90 or above. (Our medical consultants also suggest a goal of 140/90 for adults of any age who have diabetes, and for those younger than 50 with chronic kidney disease.)
That calls for lifestyle changes such as sodium restriction, weight loss, and exercise, and if those methods are ineffective, medication to lower blood pressure.
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