The American College of Cardiology recently updated existing blood pressure guidelines based on findings from the 2017 Systolic Blood Pressure Intervention Trial (SPRINT).
Previously, guidelines labeled people with a blood pressure reading of 140/90 as high risk. Now, if your reading is 130/80 you are high risk. This 10-point change means nearly half of American adults (46 percent) are now considered to have hypertension, or high blood pressure.
“This is a positive change for the general population,” says Boris Arbit, MD, cardiologist at the UCLA Health clinic in Encino. “More people will come under the attention of their physician or specialist. More people will get treatment. As a result, we will save more lives.”
The SPRINT trial found that targeting blood pressure more aggressively provided three clear benefits:
- Decreased rate of death
- Decreased rate of heart attack
- Decreased rate of stroke
“The data that went into making these guidelines is very solid,” says Dr. Arbit. “They have real scientific heft behind them.”
At-home monitoring critical to success
The new guidelines provide concrete information for practitioners about how to assess and treat patients. They are also designed to help people manage their blood pressure at home. The most effective monitoring is done at home with a calibrated blood pressure cuff, says Dr. Arbit. Other recommendations include:
- Set a specific time each day to take a reading. Dr. Arbit recommends people wake up, use the restroom and return to a seated position on an empty stomach to take the reading.
- After you take the first reading, let the cuff deflate. Wait two minutes and take a second reading.
- Keep a daily log of readings and provide it to your physician at your next visit.
“I always ask my patients to record two readings per day,” says Dr. Arbit. “Then we have a wealth of data to use in assessing blood pressure. It isn’t enough to take readings in the office; we need to know what is occurring on a day-to-day basis.”
Lifestyle modifications are the first step
Dr. Arbit says medication is often not the first step in managing hypertension. Rather, lifestyle modification comes first. Improving diet and increasing exercise can lower blood pressure. The new guidelines call for 150 minutes of moderate intensity exercise each week.
“Exercise improves high blood pressure, but also helps heart health in general,” says Dr. Arbit. “To hit 150 minutes, I tell patients they should do 30 to 40 minutes of moderate intensity exercise, three to four times per week. It can be anything they enjoy as long as they are huffing, puffing and sweating as a result.”
The other important lifestyle modification is limiting salt intake. Dr. Arbit recommends the Dietary Approaches to Stop Hypertension (DASH) diet, which is highly effective at lowering blood pressure. This diet focuses on fruits, vegetables, whole grains and low-fat dairy products, with reduced content of saturated and total fat.
“If patients follow the diet and restrict their sodium intake, there may be up to 11-point decrease in their systolic blood pressure,” says Dr. Arbit. “I also recommend the Mediterranean diet because there is an overlap in the two plans. Both not only lower blood pressure, but they also decrease the risk of stroke and heart attack, too.”