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New Efforts to Control High Blood Pressure

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Duke Health News 919-660-1306

Hypertension, or high blood pressure, causes one of every eight deaths worldwide. This makes it the third leading cause of death in the world. Recently, the U. S. government updated its guidelines for high blood pressure to help prevent and control this condition.

John Alexander, M.D., assistant professor of cardiology at Duke University Medical Center, says the so-called "JNC 7" report reflects our current understanding of high blood pressure.

"There are a lot of changes from the last set of guidelines," says Alexander. "They define a level called 'pre-hypertension,' which really recognizes that hypertension is a spectrum. Even in the range of what we used to call borderline high blood pressure or high normal blood pressure, blood pressures on the higher end of that are worse for you over the long term than blood pressures on the lower end."

So, what do the new guidelines mean for someone whose blood pressure readings would have been considered 'normal,' (120 over 80) in the past?

"The challenge with the term 'normal' is that in the United States and in other Western countries, there are a lot of people who have blood pressures that are higher than is ideal," explains Alexander. "This is a marker of risk, both risk of developing more severe high blood pressure and ultimately risk of having vascular events, heart attacks and strokes."

Alexander says he tells patients who fall into this group that nothing really has changed with the release of the JNC 7 report.

"What we now recognize is that there is this spectrum of risk, that they are at the lower end of that spectrum in terms of high blood pressure, and that these people have what we now call 'pre-hypertension,'" Alexander says. "It's also critical to recognize that there are other vascular risk factors that need to be taken into consideration when you think about how to treat high blood pressure. These include diabetes, high cholesterol, smoking and family history."

Alexander adds that one important message from the new government report is that blood pressure can be controlled more aggressively with diet and lifestyle changes, and medications when needed, across the population.

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