By Dr. Seleem Choudhury

Originally published by the Caledonian Record, Dec. 6, 2018

Under the recently updated blood pressure guidelines from The American Heart Association (AHA), nearly 46 percent of U.S. adults now would be considered to have high blood pressure.

High blood pressure, or hypertension, is when your blood pressure, which is the force of your blood pushing against the walls of your blood vessels, is consistently too high. The higher the pressure, the harder your heart has to work and the less effectively blood vessels function. On a constant basis and without intervention, this can have negative impacts on your health including heart failure, vision loss, stroke, and kidney disease.

The AHA guidelines, updated after research showed complications from high blood pressure affected people with lower readings, redefines high blood pressure, previously identified as 140/90 for the past 14 years, as 130/90. Controversy with these variations exists, as many providers believe you should focus on choosing blood pressure targets that allow for a choice based on a patient’s risk profile, susceptibility to harms, and treatment preferences and therefore use alternative specific targets for all adults depending on these factors. However, according to the American College of Cardiology, being more aggressive with blood pressure management will allow for earlier intervention and lifestyle changes to prevent a person’s blood pressure from continuing to rise to levels that could lead to heart attack, stroke, and other consequences.

High blood pressure is second only to smoking as a preventable cause of heart attacks and strokes, with heart disease in the lead as the biggest killer of Americans and Vermonters. Early investment and intervention to treat more adults is expected to lead to health gains and cost savings, and the updated guidelines are expected to help prevent three million fewer cardiovascular disease events over the next 10 years.

It’s important to remember managing high blood pressure is a public health opportunity which helps ensure healthy New Englanders. The Northeast Kingdom medical practices and hospitals have worked hard to reduce the rates of high blood pressure through awareness, treatment, and lifestyle choices. Losing weight can help, and so can avoiding excess alcohol consumption. But exercise helps even if it doesn’t result in weight loss, as the exercise itself makes your heart stronger so it doesn’t have to work as hard and decreases the force on your arteries. Sodium also plays a role in raising a person’s blood pressure and decreasing salt intake may help reduce the pressure. The biggest impact of a high sodium intake, though, is that it counters the effectiveness of high blood pressure medications.

For individuals who do need to manage their blood pressure with medication, they know it’s a tenuous partnership of managing the side effects of the medication and successfully achieving the desired pressure. For example, does the side effect of the medication outweigh being able to manage your blood pressure? Typically it shouldn’t. The side effects of blood pressure medication tend to be minor and temporary, whereas the avoided cardiovascular events can lead to serious lifetime health problems, some of which can be fatal.

Screening for high blood pressure usually occurs when you visit your primary care provider. Our region providers encourage you to request having your blood pressure taken at least twice during each visit or even three times if there is a significant difference between the first and second readings. These new guidelines don’t necessarily mean you will start taking medication; however, it does present you and your provider an opportunity to sit and talk about steps that can be taken to improve your health, about your ongoing care, and make shared decisions about treatment options and lifestyle changes, all of which are important to maintaining an ideal blood pressure.