New blood pressure guidelines urge zero alcohol and earlier hypertension treatment

A major update after six years reshapes hypertension care with stricter lifestyle rules and faster treatment plans.

The American Heart Association (AHA) and American College of Cardiology (ACC) have published new guidelines on the prevention and management of hypertension with their first major update in six years, as per CNN Health. The change that stands out most is the revision of the treatment initiation thresholds as well as the complete cessation of alcohol intake.

AHA and ACC share new guidelines on the prevention of hypertension (Freepik)

Hypertension Prevalence and Risks

The AHA and ACC estimated that almost half of the adult population in the United States is classified as having hypertension. The World Health Organization calls hypertension is commonly called the “silent killer” disease as it is mostly asymptomatic. The AHA and ACC further explain that in more severe cases, patients may have symptoms such as headaches, breathlessness, light-headedness, or epistaxis.

It is important to control blood pressure as these symptoms tend to occur in the later stages of the illness. The thresholds have not changed, with the AHA and ACC defining normal blood pressure as less than 120/80 mmHg, elevated from 120-129/80 mmHg, and hypertension as 130 mmHg. Systolic blood pressure is the first number, a contraction of the heart, and the second number is the pressure during heart relaxation, or diastolic blood pressure.

Key Changes in the New Guidelines

Under the latest recommendations, people diagnosed with stage 1 hypertension with a systolic reading between 130 and 139 will first be directed to the diet and activity intervention stream. They will be advised on regular exercise, a healthy diet, low salt intake, and a regular routine.

Now treatment is advised after three to six months with no lifestyle changes to diet. This is a shift from the 2017 guidelines, which usually started treatment at 140. Another big change is the guideline recommending no alcohol consumption whatsoever.

Prior guidelines accepted alcohol intake in moderation. However, new studies show that alcohol is a risk factor for hypertension for most people. “We put forward the ideal as abstinence,” Dr. Daniel Jones, the AHA guideline writing committee chair and a professor emeritus at the University of Mississippi School of Medicine, said.

The guidelines also recommend limiting sodium intake to 2,300 mg a day, with 1,500 mg being optimum, alongside increasing potassium through food or potassium-containing salt substitutes. Additionally, following the DASH diet, which encourages intake of fruits and vegetables, whole grains, lean meat, and low-fat dairy, is beneficial.

Adopting the right strategies is important in managing stress and healthy body weight. 150 minutes of exercise is ideal to see results. Individuals with a high body mass index are recommended to reduce 5% of their body weight. Women who are pregnant or planning to conceive a baby should closely monitor their blood pressure, as high BP can be harmful for both the mother and the child. Reducing blood pressure is beneficial for the kidneys, too, and reduces the risk of dementia.

If Blood pressure is left unchecked, it can lead to other serious issues. Such as Kidney damage, heart disease, brain stroke, and loss of vision. Over time, it can also cause the blood vessels to be damaged and increase the risk of life-threatening problems such as coronary artery tamponade and cardiac arrest. If it is diagnosed and managed timely manner, it can lead to reversal of the disease, leading to a healthy life.

FAQs

Q1. What is considered high blood pressure?

A1. A reading of 130/80 mmHg or higher.

Q2. Can lifestyle changes lower blood pressure?

A2. Yes, through diet, exercise, and stress management.

Q3. Is there a need for medication at all?

A3. Under normal circumstances, no, although medication may be necessary in the case of elevated readings.