February 2, 2018

Understanding High Blood Pressure

We’re all familiar with getting our blood pressure checked during a visit to the doctor – the inflatable cuff that slides around our upper arm and gives it a “squeeze.” Unless we’ve been diagnosed with high blood pressure (or hypertension), we may not even remember our numbers. But when the American Heart Association issued new guidelines in late 2017 on what defines high blood pressure, there was a lot of confusion about what it meant and who actually has hypertension.

Understanding the AHA High Blood Pressure Guidelines

Through a brief Q&A, UW Health cardiologist Dr. Matthew Tattersall helps to clear up some confusion and offers tips for managing your health.

What should people be aware of with the new guidelines?

There are two important points that everyone should be aware of about the new American Heart Association High Blood Pressure Guidelines.

First, there has been a change in the definition of high blood pressure. With the new guidelines, any adult with an average blood pressure of 130/80 mmHg or higher now meets criteria for a hypertension diagnosis (the previous level was 140/90 mmHg).

The second important point from the new guidelines is the importance of checking your blood pressure at home, outside of clinic, even if it was normal during a recent clinic visit.

Will more people be considered "at risk” as a result of the guideline updates?

With the guideline updates, more adults will have blood pressures that meet the criteria for a diagnosis of high blood pressure. Overall, approximately 46 percent of adults in the United States will have high blood pressure based upon the new guidelines. Having high blood pressure increases a person’s risk for a future heart attack, stroke, heart failure, and/or kidney disease. Therefore, it is important for everyone to be aware of their blood pressure numbers, to know if they have high blood pressure, and to take steps to lower their blood pressure.

UW Health has been following the recommendations listed in these new guidelines for years, so patients won’t see much difference at all. But, individuals should ask their physicians, no matter where they receive their health care, how these new guidelines will affect them.

What steps can people take to keep their blood pressure at a healthy level?

There are important steps that everyone can take to lower their blood pressure or prevent the development of high blood pressure.

One important change includes selecting lower salt (lower sodium) foods. Even if you do not add salt to your food, most prepared, frozen, and canned foods – including restaurant food – already has a high salt content.

Other steps include:

  • Limiting alcohol intake

  • Keeping a healthy weight

  • Staying active with regular exercise and physical activity

  • Quitting smoking

The DASH Diet – or Dietary Approaches to Stop Hypertension – was recently ranked by U.S. News and World Report as one of the best diets to follow. It is an evidence-based approach to nutrition that is also easy to follow.

However, if lifestyle changes aren’t enough, your physician will likely suggest that you start taking blood pressure medication, sometimes more than one. Nobody wants to be taking medication, but these drugs are generally safe if taken as prescribed, and can really do a lot to improve your blood pressure.

Why is it important to check blood pressure at home?

Home blood pressure readings can help doctors identify who has high blood pressure, because problems are not always readily apparent. To explain - there are three types of high blood pressure:

  • Sustained, which is elevated blood pressures at home and in the clinic

  • White coat hypertension - which many may have heard of - where blood pressures are elevated in the clinic but normal at home

  • Masked hypertension, where the blood pressure is normal in the clinic, but elevated at home

Home monitoring can help in a few ways – it can help identify what type of high blood pressure a person may have because it provides additional data for doctors to use in their assessments. And, if you already have high blood pressure, monitoring your blood pressure at home will help make sure your blood pressure is in a healthy range.

How do I monitor my blood pressure at home?

An upper arm cuff with an automatic monitor, available at many drug stores and pharmacies, is generally recommended. Sometimes, home blood pressure monitors are covered by medical insurance to help decrease the cost.

It is important know how to take your blood pressure consistently. There can be a number of things that may affect your reading – how recently you drank a caffeinated beverage, for example. So, if you plan to do home monitoring, make sure to speak with your physician about the proper methods so you can get an accurate reading.

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