While nearly half of Americans have high blood pressure under new guidelines, not all require blood pressure-lowering medication, based on a study of national data from 2011–2014.
Published in the Journal of the American College of Cardiology, this study looked at how new blood pressure guidelines impact treatment recommendations for U.S. adults. The new guidelines, which were released in November 2017 by the American College of Cardiology and American Heart Association, made stricter cutoffs for how we define high blood pressure. They also made stricter blood pressure goals for patients taking antihypertensive medication, hoping that tighter blood pressure control will lead to improved outcomes.
To see how new guidelines will impact treatment, researchers recently analyzed blood pressure data from the National Health and Nutrition Examination Survey. This study included nearly 10,000 American adults who completed both surveys and medical exams between 2011 and 2014.
Under previous guidelines, only 32% of participants qualified as having high blood pressure—which used to be defined as blood pressure of 140/90 mmHg or higher. But based on updated guidelines, nearly half (46%) of U.S. adults now have hypertension. New guidelines define high blood pressure as having readings of 130/80 mmHg or above.
The good news, however, is that not all 46% of adults need blood pressure-lowering medication. Under new guidelines, medication is only recommended for patients with high cardiovascular risk or those with stage 2 hypertension (defined as blood pressure of 140/90 mmHg or higher). Based on the recent analysis, the new guidelines only increase the number of adults needing medication by 2%.
Findings should also come as a relief for millions of new patients who now have high blood pressure, based on updated guidelines. For patients with low cardiovascular risk, simple changes like weight loss, a healthy diet and increased physical activity may do the trick in lowering blood pressure.
However, findings also raise concern for patients with hypertension who are already on blood pressure medication. Based on 2011–2014 data, 54% of patients on blood pressure medication fall short of the new treatment goal, which is less than 130/80 mmHg. It’s recommended that patients who don’t achieve this goal consider more intensive therapy to further reduce their blood pressure and cardiovascular risk.