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Lake Regional Cardiologist Discusses New Blood Pressure Guidelines

Wednesday, November 15, 2017

On Monday, Nov. 13, heart experts released new guidelines calling for earlier treatment of high blood pressure. The new guidelines from the American Heart Association and American College of Cardiology recommend treatment when blood pressure is 130/80 or higher.

"This change moves millions of Americans into the category of having high blood pressure," said Lake Regional Cardiologist Zubair Khan, M.D. "Research indicates these Americans are at a greater risk for heart attacks and stroke and will benefit from treating their high blood pressure earlier."

What Exactly Has Changed?

Previous guidelines recommended treating people who have a systolic pressure (the first number) of 140 and higher, or a diastolic pressure (the second number) of 90 and higher. These people were considered to have Stage 1 hypertension. Stage 2 was reached with blood pressure of 160/100 and higher.

The new guidelines lower the thresholds for both Stage 1 and Stage 2 and set the following categories:

Normal: Systolic less than 120 and diastolic less than 80

Elevated: Systolic 120-129 and diastolic less than 80

Stage 1: Systolic 130-139 or diastolic 80-89

Stage 2: Systolic at least 140 or diastolic at least 90

Why is High Blood Pressure a Problem?

"High blood pressure is associated with a higher risk for heart disease, stroke and other problems, and it won't go away without treatment," Dr. Khan said. "But treatment doesn't always mean medication. In fact, the new guidelines recommend lifestyle changes without medication for most people in the new Stage 1 hypertension category."

How Do I Lower My Blood Pressure?

Lifestyle changes that can lower blood pressure include regular exercise, decreasing salt intake, getting a proper amount of sleep, eating more fiber, eating more potassium-rich fruits and vegetables, and limiting alcohol consumption (no more than two drinks per day for men and no more than one drink per day for women).

If lifestyle changes do not bring blood pressure to a healthy level, medication may be used.

How Do I Know If I Have High Blood Pressure?

High blood pressure often has no symptoms. Regular screening is important to find it.

"The new guidelines also emphasize the importance of careful blood pressure monitoring," Dr. Khan said. "Some patients might need to monitor their blood pressure at home."

The American Heart Association provides these tips for getting an accurate blood pressure reading:

  • Be still for five minutes before the reading.
  • Don't talk before or during the test.
  • Sit with your feet on the ground and your back upright. Never take it laying down.
  • The cuff needs to be the right size and positioned at heart level.
  • Don't settle for one reading. Because the readings can fluctuate substantially, it's best to take at least two and preferably more and then average them.

"The first step in treating high blood pressure is finding it," Dr. Khan said. "If you don't know your numbers, get checked."

Lake Regional Health System provides comprehensive cardiac care. The heart team includes three board-certified interventional cardiologists, a cardiovascular-thoracic surgeon, and registered nurses and X-ray technicians who specialize in cardiac care. To find a physician, visit