Hypertension standards reveal more patients at risk

New findings warn that blood pressure will inevitably reach the danger level unless patients lose weight, the salt shaker and sedentary habits.

By Susan J. Landers, AMNews staff. June 2/9, 2003.

Washington -- Could new hypertension guidelines released May 14 by the National Heart, Lung and Blood Institute perhaps raise everyone's blood pressure a notch or two?

At least figuratively, yes.

Physicians may face new challenges convincing patients with blood pressure formerly considered normal to high-normal that they are actually in a higher risk category -- that of "prehypertension." An estimated 45 million Americans fall into this grouping.

The updated guidelines reflect a growing body of science indicating that cardiovascular damage begins at much lower blood pressure levels than previously thought. The change has very real implications for physicians who will now have to decide how much weight to give the recommendations and how to adjust their efforts to educate a larger patient population about the importance of lifestyle in preventing heart disease.

"The first thing that's going to happen will be a wailing and gnashing of teeth," said Raymond Townsend, MD, director of the University of Pennsylvania's hypertension program.

"Physicians are also going to ask, 'Is this really necessary? Is this a good idea?' " he added. "Eventually, as they scratch at the data, people are going to come around to the idea that maybe we should be doing more at an earlier point."

Even if only a few people decide to skip the ice cream cone, walk a little more and put the salt shaker away, it will go a long way toward preventing cardiovascular illness, he said.