Combating the Silent Killer of High Blood Pressure

A lowered threshhold for hypertension calls for early intervention

A man monitors his blood pressure at home, representing the importance of keeping track of hypertension.

A lowered threshhold for hypertension calls for early intervention

Nearly half of the country’s adults — 46 percent — now have high blood pressure, according to recently revised guidelines from the American College of Cardiology (ACC), the American Heart Association (AHA) and other organizations.

High blood pressure, or hypertension, occurs when the force exerted by blood on the body’s arterial walls is too great, which makes the heart work harder. There are often no symptoms. It’s a major risk factor for heart attack and stroke, accounting for the second largest number of preventable heart disease and stroke deaths, behind smoking.

The updated guidelines encourage earlier intervention against this so-called silent killer. The two numbers that make up a blood pressure measurement are the systolic pressure, or the highest pressure during a heartbeat, and the diastolic, or lowest pressure between beats. 

Here’s how the new categories break down: The upper threshold for normal blood pressure has been lowered to 120/80. There’s no longer a category for “prehypertension.” Elevated blood pressure falls between 120 and 129 systolic and less than 80 diastolic; measurements of 130–139/80–89 are considered stage 1 hypertension.

New 2017 blood pressure guidelines

  • Normal: Less than 120/80
  • High blood pressure (stage 1): 130–139/80–89
  • High blood pressure (stage 2): Higher than 140/90
  • Hypertensive crisis: Over 180/120

Those under 45 are most likely to be affected. According to the ACC, the prevalence of high blood pressure is expected to triple in men and double in women under 45.

The new rules also recommend high blood pressure be treated earlier, with lifestyle changes like quitting smoking, eating healthy, reducing salt intake, managing stress, and in some cases medication, beginning at 130/80 instead of 140/90.

According to the AHA, of the additional 14 percent of people who are now classified as having high blood pressure, only about one in five will need medication.

High blood pressure by the numbers

  • 46 percent of American adults have high blood pressure, compared with 32 percent under the old guidelines
  • 30 million additional people could be classified as having stage 1 hypertension under the new guidelines
  • 21 experts made up the committee that formulated the new rules 
  • 75 percent of men ages 55 to 74 could now be diagnosed with high blood pressure
MLB Hall of Fame pitcher Trevor Hoffman is featured on the cover of the March issue of San Diego Health.

This content appeared in San Diego Health, a publication in partnership between Scripps and San Diego Magazine that celebrates the healthy spirit of San Diego.