Dr. Samadi: New guidelines mean 50% of people have hypertension 

The change in high blood pressure guidelines mean the number of Americans under 45 who’ll be diagnosed with hypertension will soar. (Getty Images/Fuse)

The pressure is on — new guidelines recently released by the American Heart Association and the American College of Cardiology have changed the definition of high blood pressure or hypertension.

Previous guidelines that have been used for many years defined high blood pressure as 140/90 millimeters of mercury or greater. Now, the new guidelines defines high blood pressure as 130/80 or greater.


The top or first number is called the systolic pressure describing the pressure on blood vessels when the heart takes a beat, and the bottom or second number is called the diastolic pressure when the heart relaxes or is in-between beats.

What this means for the nation is tens of millions more Americans will now be told the next time they have their blood pressure taken that they have hypertension. It is estimated that with this change the number of men under the age of 45 who will be told they have high blood pressure will triple and the number of women under age 45 will double.

It was back in 2003 when the last time any diagnostic revisions had been made on criteria for hypertension. The reasoning for changing the guideline was growing evidence that blood pressure much lower than had been considered normal greatly reduces the chances of heart attack and stroke as well as overall risk of death.

A large federal study in 2015 called SPRINT found that lowering blood pressure standards from 140/90 to 130/80 could improve the fight against cardiovascular disease helping to lower the risk of death.

The current number of Americans who have high blood pressure is 72 million. But with this change in guidelines, that number will rise to 103 million. Does this mean there will be a significant number of Americans who will now have to be taking blood pressure medication?

The answer to this appears to be no — it is expected only 4.2 million of the expected 31 million more Americans who fall under this new guideline will actually need to be on drug treatment. The rest should be able to manage and meet their goals of obtaining a healthier blood pressure with lifestyle changes.

For the past 80 years heart disease has been the leading cause of death. Every one of us either knows someone or has a relative who has suffered a heart attack, stroke, or been diagnosed with some form of heart disease. High blood pressure is one of the primary risk factors second only to smoking as a preventable cause of heart attacks and strokes.

High blood pressure is referred to as the silent killer. There are few, if any, symptoms one has, making it imperative for all of us to have our blood pressure checked at least once a year at an annual physical.

The goal is that many of the additional people, who now will be told they have high blood pressure and need to reduce it, can make lifestyle changes without having to resort to taking high blood pressure medications.

Here are some of the best ways all of us can do to keep our blood pressure in a normal range lowering our risk of cardiovascular disease:

Eat a heart-healthy diet

Become a lover of fruits and veggies. Choose antioxidant-rich produce full of potassium and magnesium while low in sodium have been shown to improve vascular health while reducing inflammation.

Exercise daily

Be physically active at least 30 minutes most days if not every day of the week. Get your heart rate elevated with aerobic exercise (brisk walking, jogging, swimming, dancing, jumping rope, bicycling, etc.) which has the potential to lower systolic blood pressure as much as four to nine points.


Lose weight

Dr. David Samadi
Dr. David Samadi

Individuals who are overweight to obese are putting themselves at risk for high blood pressure. There is an approximate threefold risk in increasing high blood pressure in anyone who is carrying extra weight.

Reduce sodium intake

Limit sodium intake to no more than 2300 milligrams a day. Following the DASH Diet (Dietary Approaches to Stop Hypertension) has been shown to help immensely those needing to lower their blood pressure.

Put down that alcoholic drink

Drinking alcohol has the potential to raise blood pressure. Limit alcohol to one drink a day if you are a woman or two drinks a day if you are a man.

Increase potassium-rich foods

Load up on foods high in potassium — sweet potatoes, white beans, bananas, honeydew melon, orange juice, avocado, and spinach. These high blood pressure warriors help relax blood vessels and eliminate sodium.

Chill out

Stress is a daily thing for all of us but chronic stress can lead to high blood pressure. When we learn to relax this can activate genes associated with dilating the blood vessels utilizing blood sugar, and inactivates genes associated with vascular inflammation and constriction. Start by practicing techniques of meditation, deep breathing exercises, yoga, and guided imagery.

Stop smoking

Kicking a smoking habit is one of the single biggest factors one can do to lower blood pressure. Cigarettes' nicotine constricts blood vessels making the heart work harder, leading to hypertension. Just quitting smoking can lower systolic blood pressure by two to eight points.

Treat sleep apnea

Obstructive sleep apnea is a possible contributor to hypertension. Getting diagnosed and then treating it with a continuous positive airway pressure or a dental appliance may help lower blood pressure and give you a better night's sleep.

