If you take medication to treat your high blood pressure, listen up: New guidelines released this week in the Journal of the American Medical Association have increased the hypertension threshold that warrants drug treatment.
After reviewing the effects of treatment on high blood pressure for men and women 18 and older, the expert panel concluded that fewer patients with hypertension may need prescription treatment than previously thought. More specifically:
For adults over 60, medication is now recommended for blood pressure greater than 150/90 mmHg. This raises the systolic blood pressure (the top number) threshold up from 140, while diastolic blood pressure (the bottom number) stays the same. Which spells good news for patients with blood pressure hovering at the borderline level.
“This means less medication in dose or in number,” says Curtis Rimmerman, MD, a staff cardiologist at the nonprofit academic medical center The Cleveland Clinic.
For adults under 60, there’s not enough evidence to recommend a treatment threshold for high blood pressure. Say what? While the guideline authors expressed the opinion that treatment should still be prescribed for blood pressure greater than 140/90, they concluded that the evidence does not support a formal recommendation.
In other words, your doc might be more likely to suggest lifestyle changes rather than automatically pull out her prescription pad to manage moderate high blood pressure.
To experts, the shift makes sense. “If you have high blood pressure, as long as you don’t have active symptoms [like heart disease], all doctors want to employ a program of risk factor modifications through diet, exercise, and weight loss first,”
Dr. Rimmerman says. If those moderate changes don’t work, then it’s time to think about popping a pill. “In my practice, I give people three months or so. Then we review their progress, and if there’s not much, then they’ll get treated,” says Dr. Rimmerman.
The bottom line? While the study authors point out that the updated guidelines don’t redefine what constitutes as high blood pressure, using medication to treat lower levels of high blood pressure might not be as effective as experts previously thought.
Still, don’t ditch your prescription quite yet. “Bring this up as a point of discussion with your doctor at your next follow-up appointment,” Dr. Rimmerman recommends.
Source: Prevention
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