Of the estimated 14 percent more adults to be classified with high blood pressure, about one in five will need medication, according to Paul Whelton, M.D., who chaired the guideline writing committee. But taking into account the overall population of adults who now will have hypertension, the guide predicts only a small percentage more should be prescribed medicine for it, compared with the previous guideline’s recommendations released in 2003.
Instead, the guideline, published in the AHA’s journal Hypertension, emphasizes that doctors need to focus on a whole framework of healthier lifestyle changes for patients.
“We need to send the message that yes, you are at increased risk and these are the things you should be doing,” said Whelton, chair of global public health at Tulane University in New Orleans. “I’m not saying it’s easy to change our lifestyles, but that should be first and foremost.”
The recommendations for a heart-healthy diet include reducing salt and incorporating potassium-rich foods such as bananas, potatoes, avocados and dark leafy vegetables. The guideline also gives specific suggestions for weight loss, quitting cigarettes, cutting back on alcohol and increasing physical activity.
The guideline, the first comprehensive one in 14 years, homes in on making sure doctors’ offices and patients understand how to accurately measure blood pressure and diagnose hypertension in the first place.
Hypertension occurs when the force of blood pushing against vessel walls is too high. This added pressure causes the heart to work too hard and blood vessels to function less effectively. Over time, the stress damages the tissues within arteries, which can further damage the heart and circulatory system.
Often called the “silent killer” because there are often no obvious symptoms, hypertension accounts for more heart disease and stroke deaths than almost all other preventable causes. It’s second only to smoking.
Robert M. Carey, M.D., vice chair of the guideline writing committee, said he expects some controversy over how the report treats older adults. It recommends people 65 and older be treated to the same 130/80 goal as younger patients. A guideline early this year from the American College of Physicians and the American Academy of Family Physicians suggested patients 60 and older be held to a standard below 150/90.