Feeling the pressure? | Health – tech2.org

Feeling the pressure? | Health


Was your blood pressure, which was once acceptable, suddenly reformulated as "high"?

If so, it is among 1 in 7 Americans who suddenly find themselves on the wrong side of an important dividing line, thanks to new blood pressure patterns recently established by the American Heart Association (AHA) and the American College of Cardiology.

And if so, you may want to schedule an appointment with your doctor.

Previously, a blood pressure of 140/90 mm Hg was the "high" threshold. Now, that standard has been reduced to 130/80.

Thanks to that change, now almost half of all adults, 46 percent, to be exact, have high blood pressure.

One of the committee members who helped write The New Guide is Sandra Taler, a professor of medicine and a Mayo Clinic staff consultant in the division of nephrology and hypertension.

In addition to reducing the definition of high blood pressure, the new guidelines also eliminate the old "prehypertension." category, previously used to describe patients between 120 and 139 systolic blood pressure.

Instead, the new categories are as follows, according to the American Heart Association:

Normal : Less than 120/80 mm Hg

Elevated : systolic between 120-129 and diastolic less than 80;

Stage 1 hypertension : systolic between 130-139 or diastolic between 80 -89;

Stage 2 hypertension : systolic at least 140 or diastolic at least 90 mm Hg;

Hypertensive crisis : systolic on 180 and / or diastolic on 120.

The "elevated" stage, which replaces the term "prehypertension" may make it clear to patients that their blood pressure is already It is not considered "normal" when it increases above 120, Taler said.

"The intention was to make people think about hypertension and not just (say)," Oh, this is fine ", said Taler. "Prehypertension may be stronger, but prehypertension just did not work, you know, you're pre-dead, they're all pre-dead, it did not make people think, I'm really at risk here and I need to change. roads ".

Most people should be able to treat their blood pressure without medication, Taler said, especially if a risk badessment is done and the threat of heart disease is less than 10 percent.

However, those changes are not as simple as "not salting the egg on Sundays," Taler said.

Learning to cook to avoid excess salt, eat less, and exercise to lose weight can reduce a patient's numbers.

Since 140 and more are now considered stage 2 hypertension, Taler said the medication will be used more often along with lifestyle changes.

Taler said she is used to patients who get scared when taking medications they can take for the rest of their lives. [19659003] If a patient responds well to changes in medication and lifestyle, however, she tells them that they can reduce their medication and control their blood pressure. As long as it remains within the target area, they are golden.

"But if you stop those efforts, take care of yourself, start to travel, no longer observe your salt, recover some weight, then it is very likely that you will have to take medicines again, since those changes in lifestyle They are the ones that are treating your blood pressure, "he said.

Dana Baker is familiar with the anxiety that comes with the initial medications.

Baker is an employee at the Mayo Clinic in Florida, working in corporate relationships for executive health.

"I was in my 30s, and a little overwhelmed by," What is high blood pressure? Does it mean anything? ", Baker said. [19659003] After being diagnosed with high blood pressure – 150/100 – 10 years ago, Baker began trying to improve his blood pressure using diet and exercise. He lost some weight, but was not able to lower his blood pressure until he found the right medication.

And she was not completely convinced until her doctor connected her numbers in the risk badessment, which showed that she had a 30 Percent chance of developing heart disease.

A few days after the new guidelines appeared, he was monitored for blood pressure: 125/80.

Baker is also used to controlling his own blood pressure outside the doctor's office. She was asymptomatic and had a "good BMI," so she first bought a wrist cuff to control her own blood pressure and make sure her measurements were not just "white mantle syndrome."

Since then, Baker received a cuff that fits his arm to track his own blood pressure. Advise other patients with high blood pressure to investigate the options, then choose one that is accurate and that they will actually use.

"The doctor takes your blood pressure in the office, and it's kind of intimidating to think about it, get a blood pressure cuff that looks like the one in your doctor's office and know what to do with it," he said. Baker. "You have this big old machine on your desk, but it's okay, (when) you have your physical, you need to show where your numbers are, not just the number you have the day you enter" [19659003] Not everyone needs a monitor in the home, said Taler. People with normal blood pressure can get measurements once or twice a year at the controls.

When a patient enters the "high" range, however, "it would be reasonable to measure it at home," he said.

"Some people are taller in the doctor's office, some people are taller in the home (or) they may be taller at work," he said.

Having a machine at home is not always reliable; they are not reviewed frequently, so Taler does not recommend them as the only detection option.

However, home readings can provide evidence that helps smooth out the natural variability of blood pressure readings.

"Blood pressure is quite variable and high reading is not enough to say: 'You need medicine' or 'you need more medicine'," said Taler. "We really need to see a pattern."

Blood pressure guidelines have not been updated since 2003, despite the fact that many studies have been published since then.

In 2014, work began on a complete update of the EE. UU definition of hypertension and treatment guidelines. During the writing period, the Systolic Blood Pressure Intervention Trial ended.

The SPRINT studied more than 9,000 people with blood pressure of 130 or more systolic. They were randomly badigned to one of two groups: one that pointed to a blood pressure less than 120 after treatment and another that pointed to 140 or less.

After just over three years, the study ended because the members of the second group were approximately 25 percent more likely to develop cardiovascular disease. About 8 percent of patients in group 140 developed a cardiovascular event: a heart attack or other health problem. About 6 percent of the lower group did so.

Criticism has leveled off in the study because of its apparent low importance, but Taler argues that it is still significant.

"It is difficult to argue with the results, they were true for older people, they were true for people with kidney disease, they were particularly true for people who had evidence of cardiovascular disease or had a high risk of cardiovascular disease," He said. "And particularly the group of older people, where people are worried about lowering their blood pressure too much, showed benefits."

The SPRINT trial was not the complete basis of the new guide. A meta-badysis of other studies since 2003 showed benefits in lowering blood pressure beyond 140/90.

Some rejections against the new guidelines have accused writers of trying to create more than one market for blood pressure medications, Taler said.

By design, no one on the committee worked for pharmaceutical or pharmacology companies, she said. And although they do talk about treatments with generic drugs, the focus of the guidelines is on changes in lifestyle, which she calls "the first line of treatment."

American Heart Association News offers the following tips for taking blood pressure:

• It takes two readings. Reduce variability

• Avoid smoking, taking caffeine and exercising 30 minutes before taking your blood pressure.

• Sit still five minutes before.

• Keep your arm cuffed on a flat surface, like a table, at the level of the heart. Sit up straight, with your back straight and your head held high.

• Do not speak during the test.

• Wait a minute and try the test again. Keep a record and bring it to doctor's appointments.

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