High blood pressure is one of the most common health conditions in the U.S., affecting nearly half of the adult population. High blood pressure, also known as hypertension, can lead to serious problems such as a heart attack or stroke. However, despite the condition’s prevalence among Americans, many don’t even know they have it, which is why high blood pressure is often referred to as “the silent killer.” In response to the prevalence of hypertension, the standard guidelines for diagnosing and managing high blood pressure were significantly revised in 2017, following substantial evidence demonstrated that earlier intervention could improve patient outcomes and reduce the potential for serious consequences. The 6 primary changes to the high blood pressure guidelines are:
At CardioVascular Health Clinic, we’re proud to be at the forefront of advanced heart and vascular care. Our multidisciplinary team of experts is nationally recognized for delivering leading-edge diagnostics and treatments for a broad spectrum of cardiovascular conditions—including high blood pressure. With decades of experience, cutting-edge technology, and a patient-first approach, we provide personalized care tailored to each individual’s needs. We’re committed to empowering our patients with important information like what blood pressure is, what the new guidelines are, and what it means for them, so we can help our communities achieve their healthiest heart and their healthiest life.
Blood pressure is a vital sign that indicates how forcefully your blood is pushing against the walls of your arteries. It's measured using two numbers reflecting the two different forces that occur during one heartbeat, the systolic and the diastolic.
Blood pressure is typically measured in millimeters of mercury (mm Hg) and recorded as systolic over diastolic. Most people may be familiar with 120/80 mm Hg, which is the ideal reading for optimal heart health.
As your blood pressure increases, so does the systolic pressure, indicating the increased effort your heart has to make in order to pump blood. The diastolic pressure typically rises as well, but may also remain the same or even decrease, especially in older adults. This is referred to as isolated systolic hypertension, when the systolic pressure is elevated by the diastolic pressure is either normal or only slightly elevated.
Chronically elevated blood pressure forces your heart and arteries to work harder, increasing the risk of heart disease, stroke, kidney damage, and other life-threatening complications. Because hypertension often develops gradually and without obvious symptoms, many people don’t realize they have it until damage has already begun. This is why early detection and ongoing monitoring are essential, as is understanding your personal risk factors for developing high blood pressure.
These may include:
While blood pressure screening should be a part of every adult’s routine health care, those with risk factors may need to monitor their blood pressure more frequently.
The guidelines for high blood pressure were first developed in 1977 and helped establish a clinical framework for identifying, diagnosing, treating hypertension. These guidelines are not updated at regular intervals, but rather when new research or data suggests a revision may be beneficial to patient treatment. The 2017 revisions–which are the current guidelines–are the first change in nearly 14 years and were published by the American Heart Association (AHA) and the American College of Cardiology (ACC) in collaboration with several other medical organizations as a result of new data findings, particularly from the SPRINT trial (Systolic Blood Pressure Intervention Trial).
The SPRINT trial found that lowering systolic blood pressure targets below previously accepted levels significantly reduced the rates of major cardiovascular events and death. Patients in the intensive treatment group, which targeted a systolic BP of less than 120 mm Hg, had better outcomes than those with higher targets, making the evidence clear: the earlier hypertension is diagnosed and treated, the better the outcomes. By shifting the focus to prevention, these updated guidelines may now reduce complications by intervening sooner before permanent damage occurs.
For some people, these updates may reclassify them as having high blood pressure when they were previously considered borderline. While that can feel unsettling, it’s important to understand the intent: identify risk earlier and intervene before complications arise. Blood pressure often fluctuates, so it’s important to track your blood pressure and note any rising numbers, and though a single elevated reading doesn’t necessarily mean you have hypertension, it does mean you should pay close attention, monitor your numbers, and discuss any changes with your healthcare provider.
The updated guidelines introduced several important changes in how blood pressure is categorized and managed. These changes go beyond simple semantics to improve the way you–and your provider–assess your risk of developing high blood pressure and treat the underlying causes before the condition worsens.
The threshold for a high blood pressure diagnosis was lowered.
Old definition:
New definition:
While this change may not seem significant, it allows high-risk individuals, particularly younger adults and those with mild elevations, to be identified earlier and guided towards preventative care before actually developing high blood pressure.
To identify at-risk individuals earlier, a new category was also introduced:
While this level isn’t considered hypertension, it’s also no longer considered “normal” either. This category serves as a warning sign that an individual’s blood pressure may be trending upwards, and lifestyle changes are recommended to prevent further progression.
The new guidelines define the stages of high blood pressure as follows:
This more precise breakdown helps physicians tailor treatment plans based on risk level and coexisting conditions.
The term “prehypertension” has been phased out as it was often seen as too vague and didn’t clearly signal the need for intervention. Replacing it with the “Elevated” and “Stage 1” categories encourages earlier and more specified clinical action.
One of the biggest shifts in the new guidelines is an increased emphasis on lifestyle changes as a first-line treatment, particularly for those in the Elevated and Stage 1 categories who are otherwise at a low risk of cardiovascular events.
Recommended lifestyle changes include:
These steps have been shown to lower blood pressure significantly and, in many cases, delay or prevent the need for medication.
Medication is still a critical part of managing high blood pressure but its use is now more targeted. For individuals with Stage 1 hypertension and a history of cardiovascular disease (or elevated risk), medication is often recommended in addition to lifestyle changes. For those with a lower risk, lifestyle changes may be sufficient early on with follow-up monitoring.
With the new updates to high blood pressure guidelines, you can take better control of your heart health sooner, before irreversible damage takes place, and CardioVascular Health Clinic can help. Whether you’re currently struggling with high blood pressure or are unsure whether–or where–your readings fall into the new categories, we offer a full range of services to diagnose, treat, and manage hypertension accurately and effectively.
When it comes to high blood pressure, even small steps toward being proactive can lead to big improvements in your overall health, and, with the experienced team of vascular and cardiovascular specialists at CardioVascular Health Clinic, you don’t have to do it alone. Schedule a consultation today to start taking charge of your high blood pressure, your heart, and your health.
