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Blood Pressure Guidelines

In late 2017, the American Heart Association and the American College of Cardiology released new guidelines that expand the definition of high blood pressure. Previously, anything above 140/90 was considered a risk factor for cardiovascular problems; that number has now changed to 130/80.

The revision will add an estimated 31 million Americans to the ranks of the cardiac-challenged, marking nearly half of Americans as hypertensive, a condition that’s seen as a precursor to heart attack and stroke.

Rita Redberg, MD, MSc, FACC

Professor of medicine at University of California, San Francisco, and editor of JAMA Internal Medicine

Rita Redberg

“I worry about the negative effects of labeling a lot of healthy people as suddenly having a disease, or even a predisease, when it’s not clear that the benefits of treatment outweigh the risks of medications. I do not plan to change my recommendations based on the new guidelines.

“One does not need to change the definitions for hypertension in order to recommend a healthy diet, activity, and not smoking.”

P. Michael Stone, MD, MS

Integrative physician at Stone Medical, PC, in Ashland, Ore.

Michael StonePhoto courtesy of IFM

“So often we lose track of how sleep, exercise, diet, thoughts, emotions, and relationships change blood pressure. To me, it’s not that we are suddenly identifying a huge proportion of the population that needs more medication; we are trying to be honest about how lifestyle factors affect health, and how over time our choices can lead to stroke, heart attack, and disability. The new guidelines offer a great opportunity to focus on modifiable lifestyle changes sooner, immediately upon diagnosis.”

Mimi Guarneri, MD, FACC, ABOIM

Integrative cardiologist and president of the Academy of Integrative Health & Medicine

Mimi Guarneri

“I favor the new guidelines. Hypertension is a completely modifiable risk factor . . . and research shows that lifestyle change is successful in lowering blood pressure. Studies show that a diet high in green leafy vegetables, which are rich in potassium, can lower blood pressure. So can losing weight and lowering salt intake. Meditation has been studied in hypertensive African Americans . . . [and shown to decrease] stroke and heart-attack risk.”

Yousef Elyaman, MD

Board certified in internal, functional, and integrative medicine, and director of Absolute Health in Ocala, Fla.

Yousef Elyaman

“Whenever you try to group people, there’s no individuality. A patient may be at 135, but he’s in a great relationship, doesn’t drink, and exercises. He’s going to be seen the same as one who eats junk food and sits all day.

“But you have to start somewhere, and we now have a stronger argument for getting patients to work on lifestyle earlier. If I tell you you’re hypertensive, you’re likely to act sooner to make lifestyle changes. And that’s good.”

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