Blood pressure guidelines and treatment change

By LEAH NESTOR

The Exponent Telegram

CLARKSBURG, W.Va.  — The American Heart Association has changed the guidelines for what is considered high blood pressure, along with treatment plans.

Previously defined as Stage 1 hypertension was a blood pressure reading of 140/90, but has now been changed to 130/80. Guidelines now suggest not treating stages 1 and 2 hypertension unless the patient has another cardiovascular issue such as heart attack, stroke or diabetes.

Dr. George Sokos said the changes were made to prevent worse conditions down the line. Sokos is the director of Advanced Heart Failure at the Heart and Vascular Institute for West Virginia University Medicine.

He said people with longstanding high blood pressure are more prone to strokes and kidney disease.

“That’s why they made the change, so you can catch things earlier to prevent bigger things from happening down the line,” Sokos added.

Prior to the changes, the Centers for Disease Control and Prevention estimated that 29 percent of Americans had high blood pressure.

Because the threshold for hypertension has been lowered, more people will be diagnosed with it, increasing prescription drug use, Sokos said. Although there will be more people on prescription drug use, he said there will also be more people on appropriate prescription drugs.

“It’s really to prevent future bad outcomes from happening,” Sokos stated.

However, because stages 1 and 2 are recommended not to be treated with prescription drugs, there is a continued push for lifestyle change, he indicated.

Risk factors associated with hypertension include being overweight and consuming a high sodium diet.

“Simple lifestyle modifcations like exercise and changing your diet can make a big difference,” he stated. “It really can help you avoid treatment with medications.”

He added that non-medication treatment — diet and exercise — is cheaper and is an aspect of life that people have some control over.

West Virginia University clinical dietitian Alyssa Paglia said the guidelines refer to diet in a more concise way.

“The American public has been browbeaten with all kinds of dietary recommendations, food fads. … It’s confusing and it’s overwhelming for people, I think, who are genuinely interested in making a change,” she stated.

The guidelines mention a heart healthy diet, the DASH Diet or Dietary Approaches to Stop Hypertension. The diet is plant-focused, including vegetables, fruits, nuts, low fat dairy, lean meat and fish, with an emphasis on whole grains rather than starchy or sugary foods.

“Basically, it’s focused on filling up on wholesome foods. So it’s kind of keeping it simple in a world where there are so many processed options out there — just really getting down to the whole foods,” Paglia added.

Concerning the new guidelines in general, Paglia said it shows the medical community is constantly evolving.

“The more often that things are updated the better, because it’s showing that we’re expanding our knowledge and really getting the most current and best data to help our patients,” Paglia said.

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