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High blood pressure redefined: 130 is the new high

By Lee R. Watkins, Special to TSDMemphis.com

The number of U.S. adults considered to have high blood pressure will increase dramatically under new guidelines implemented by medical experts on Monday.

The guidelines, published by the American Heart Association and the American College of Cardiology, were presented at the association’s 2017 Scientific Sessions conference in Anaheim, Calif.

The groups determined that the reading of 130/80 is considered hypertensive, down from the previous 140/90.  It is the first revision of the guidelines since 2003, designed to help people address the potentially deadly condition much earlier.

Under the new guidelines, 46 percent of U.S. adults, many under the age of 45 will be considered hypertensive, or having high blood pressure.  Under the previous guidelines, 32 percent of U.S. adults had high blood pressure.

By lowering the definition of high blood pressure, experts hope that early intervention will prevent the disease and its complications.

“I think it’s good because we have more evidence that lower pressures are good,” said Dr. Frank A. McGrew, coordinator of clinical research for the Stern Cardiovascular Center of Memphis.  “Proud to see it being acknowledged by an outstanding body of health leaders.

“As always we start with lifestyle and diet – low-salt diet, low-fat diet and exercising,” said McGrew. “Many of these people will need drugs to lower (high blood pressure).

McGrew has done extensive research on African-American heart disease. Ten years ago, he initiated the African-American Heart Failure Trial, or A-HeFT.  During the trial, McGrew and other researchers discovered a specific medicine that would dramatically reduce the complications of heart failure for African Americans. It was the first time a specific medicine was targeted for African Americans with heart failure.  The trial is still ongoing. Patients in the trial receive the medicine free for several years.

There are two major factors that contribute to the troubling blood pressure rates in  Memphis. The city  has an older population compared to other cities, and African Americans represent about 60 percent of the Memphis population. Also, African Americans are more likely to have high blood pressure than Caucasians, said McGrew.

“It’s a combination of salt-intake and genetic make-up that makes them (African Americans) hold on to salt more than Caucasians,” McGrew said. “If you give equivalent salt diets to Caucasians and African Americans, African-Americans’ blood pressure would rise more because they don’t pass salt out of the body as readily as Caucasians do.”

The new guidelines also removed old categories such as “pre-hypertension,” which was a top (systolic) reading of 120 to 139 or a bottom (diastolic) number between 80 and 89.  Normal blood pressure still will be considered 120/80.

High blood pressure accounts for the second largest number of preventable heart disease and stroke deaths, second only to smoking. It’s known as the “silent killer” because often there are no symptoms.

Under the new guidelines, experts predict the number of young men with hypertension will triple, and the number of women with high blood pressure will double.

“Younger females are more likely to get routine medical care through their OB-GYN,” said McGrew. “A younger male is less likely to have a routine doctor visit.”

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