The American Heart Association’s Heart Month kicked off this weekend with Go Red Day to motivate women to take action against heart disease.  We would like to continue the focus on heart disease, new rules around blood pressure readings, and a look at symptoms of heart attack. 

Hypertension Background

In November 2017, the rules changed about what classifies as high blood pressure, also known as hypertension. Experts looking at all the newest data defined hypertension as a reading of 130 on the top or 80 on the bottom. In the past, the standard was 140/90.

People with readings of 130 as the top number or 80 as the bottom one now are considered to have high blood pressure, according to the guideline released Monday by the American Heart Association. High blood pressure used to be defined as 140/90.

The change means 46 percent of U.S. adults are identified as having high blood pressure, compared with 32 percent under the previous definition. A blood pressure of less than 120/80 still will be considered normal, but levels at or above that, to 129, will be called “elevated.”

“Yes, we will label more people hypertensive and give more medication, but we will save lives and money by preventing more strokes, cardiovascular events and kidney failure,” said Kenneth Jamerson, M.D., Ph.D., professor of internal medicine and hypertension specialist at the University of Michigan Health System. He is one of 21 experts on the guideline writing committee. “If you are going to put money into the healthcare system, it’s to everyone’s advantage if we treat and prevent on this side of it, in early treatment.”

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.

For more information or to see the guidelines, visit the 2017 Hypertension Guideline: Highlights for Clinical Practice.

New Rules

The AHA, the American College of Cardiology and nine other health professional organizations followed a rigorous review and approval process to develop this first update since 2003 to comprehensive U.S. high blood pressure guidelines.

Here are the new rules from John Warner, M.D., MBA; President, American Heart Association, 2017-18.

• High blood pressure, previously defined as ≥140/90 mm Hg, is now defined as ≥130/80 mm Hg. This change reflects the latest research that shows health problems can occur at those lower levels. Risk for heart attack, stroke and other consequences begins anywhere above 120 mm Hg (systolic), and risk doubles at 130 mm Hg compared to levels below 120. This lower threshold increases the prevalence of high blood pressure among U.S. adults 20 and older from 32 percent to 46 percent.
• Blood pressure in adults will be categorized as normal, elevated, stage 1 hypertension or stage 2 hypertension. We have moved away from the category “prehypertension.”
• Determination of eligibility for blood pressure-lowering medication treatment is no longer based solely on blood pressure level, but now also considers cardiovascular disease risk level.

Symptoms

Some heart attacks are sudden and intense — the "movie heart attack," where no one doubts what's happening. But most heart attacks start slowly, with mild pain or discomfort. Often people affected aren't sure what's wrong and wait too long before getting help.

Take Action!

Immediately call 9-1-1 or your emergency response number so an ambulance (ideally with advanced life support) can be sent for you. As with men, women's most common heart attack symptom is chest pain or discomfort. But women are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting, and back or jaw pain. Learn more about heart attack symptoms in women.

Learn the signs, but remember this: Even if you're not sure it's a heart attack, have it checked out (tell a doctor about your symptoms). Minutes matter! Fast action can save lives — maybe your own. Call 9-1-1 or your emergency response number.

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