A New Era of Hypertension: The Updated Guidelines and How They Affect You

By Grace Bellinger, NPHR Blog Editor

Last week, during the American Heart Association Scientific Sessions, the nation’s leading experts announced new blood pressure guidelines. High blood pressure is a major risk factor for heart attack and stroke, in fact it is second only to smoking as a preventable cause of these events. Cardiovascular disease is the leading cause of death in the United States, so there is good reason to pay close attention to your blood pressure (BP). More information about the risks of high blood pressure can be found here. Younger adults should also maintain a healthy BP in order to prevent the start of atherosclerosis, since the formation of plaque cannot easily be reversed later in life.

Healthy readings have always been a systolic blood pressure under 120 mm Hg and a diastolic blood pressure under 80 mm Hg. Under the new guidelines, high blood pressure is defined as 130/80 for those with a significant risk of heart attack or stroke, rather than the previous 140/90. A blood pressure below 130/80 should be the goal for those with more than a 10% risk of heart attack or stroke in the next 10 years. This risk depends on various factors such as age, gender, cholesterol, and medical history. The guidelines committee has developed a risk calculator for people 40-79 years old at https://ccccalculator.ccctracker.com/.

Those with less than a 10% risk are encouraged to keep their blood pressure below 140/90, which is consistent with the previous guidelines. However, this group should still consider changing their lifestyle by getting in the habit of eating healthier and exercising more. Such changes can lower systolic blood pressure by approximately 4 to 11 mm Hg for those with hypertension.

The updated categories are listed in the table below. People who fall in Hypertension Stage 1 should implement lifestyle changes, whereas those in Hypertension Stage 2 are likely to be prescribed both medications and lifestyle changes. The guidelines were changed after large trials showed that aiming for a lower BP with more aggressive treatment decreased the risk of cardiovascular disease and death. More information about blood pressure readings can be found here.


With the new guidelines, 46% of adults will be considered hypertensive, compared to 32% under the previous guidelines. This means an additional 14% of adults will technically have high blood pressure under the new definition, but only an extra 2% of adults will require medication. There is no need to be alarmed by the new guidelines, just be aware of your BP and make an effort to keep it below 120/80. Blood pressure should be checked at least once a year, so if you are due for a check up be prepared for the healthcare professional to mention the new recommendations. Many pharmacies also have a pressure cuff machine that you can use to check your BP for free.

Next Steps for Adults:

  1. Calculate your risk of heart attack or stroke in the next decade.
  2. Check if you are due for a doctor’s visit and/or have your blood pressure taken at your local pharmacy.
  3. Respect the new guidelines and your healthcare professional. If your provider recommends ambulatory blood pressure monitoring (ABPM) you should strongly consider accepting  the suggestion. If they have reason to bring ABPM up, it is in the best interest of your health, regardless of convenience.
  4. Consider applicable lifestyle changes such as efforts to lose weight, eat healthier, exercise more, limit alcohol consumption, and avoid smoking. Adopting these habits can be as effective or even more effective than medication!



About NPHR Blog (339 Articles)
The is the blog of the Northwestern Public Health Review journal. The blog and journal are both student run and contain research articles, opinions, interviews and other content pertaining to public health.

1 Comment on A New Era of Hypertension: The Updated Guidelines and How They Affect You

  1. Greensboro Imaging // March 13, 2018 at 6:14 pm // Reply

    Awesome post! At Greensboro Imaging, we also offer some good insight into cardiovascular disease risk factors and preventative measures. You can read all of the information here: https://www.greensboroimaging.com/2018/02/26/lets-fight-cardiovascular-disease/

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