New Blood Pressure Guidelines Could Lead To Millions More Taking Hypertension Drugs

The threshold for what is considered high blood pressure has been revised down under new guidelines, which may place nearly half of all Americans at a level of concern, and doctors are likely to start recommending that millions more start taking blood pressure medications. 

On November 13, the American College of Cardiology and the American Heart Association Task Force on Clinical Practice Guidelines issued new recommendations for doctors about when to consider patients at risk of high blood pressure, known as hypertension. The guidelines were published in the medical journal Hypertension.

The new guidelines call for healthcare professionals to begin treating high blood pressure at readings of 130/80, as opposed to the previous threshold of 140/90. The new number had been considered normal, controlled blood pressure, until these new guidelines.

The change means that 46% of all Americans are now considered to have high blood pressure. That is a 14% increase from the previous guidelines, raising the number of Americans with high blood pressure from 72.2 million to 103.3 million, the report notes.

Studies have linked high blood pressure to an increased risk of cardiovascular disease (CVD), and lowering blood pressure has been shown to reduce those heart risks.

“In 2010, high BP was the leading cause of death and disability-adjusted life years worldwide,” the report notes. “In the United States, hypertension accounted for more CVD deaths than any other modifiable CVD risk factor and was second only to cigarette smoking as a preventable cause of death for any reason.”

In addition to setting thresholds for what is considered hypertension, the guidelines also give recommendations on proper measurement, monitoring and risk factors. The report identifies obesity, sodium intake, low potassium, low physical fitness, and alcohol use as the primary drivers of hypertension.

It also identified the use of caffeine and certain drugs, such as amphetamines, antidepressants, atypical antipsychotics, decongestants, immunosupressants, birth control pills, herbal supplements, over-the-counter pain killers, and corticosteroids as substances that those concerned with high blood pressure should avoid if possible.

Researchers who developed the guidelines acknowledge that their findings and recommendations could be controversial to some, noting that the judgment of each patient’s doctor was still paramount.

“[C]linical guidelines are increasingly required to manage the large body of accumulated knowledge related to diagnosis and management of high BP. However, guidelines often cause controversy and confusion when competing recommendations are made by different ‘expert’ groups or when changes in definitions, treatments, or treatment goals are introduced,” the guidelines state. “Now may be the time to begin the investigation of the impact of guidelines on clinical practice, costs, and patient outcomes, as well as ways to facilitate communication and collaboration between different guideline-developing organizations.”