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Wellsource Blog

Changing the Rules - New Blood Pressure Guidelines for Population Health

Written by Wellsource, Inc.

July 30, 2018


Sometimes the rules change. Even for something that has been around for 150 years. Just this year Major League Baseball (MLB) announced that it was creating new rules to shorten the overall length of games. And for good reason. Game times were averaging three hours and eight minutes last year—and that’s not including extra innings for ties!

Sometimes it’s necessary to update the rules.

In 2017 the American Heart Association and American College of Cardiology changed their guidelines so that a reading of 130/80 is considered high blood pressure, rather than the former minimum of 140/90.

Science found that blood pressure between 130 and 139/80 and 89 is more dangerous than health care used to think. At these levels, says Dr. Paul Whelton, “You’ve already doubled your risk of cardiovascular complications compared to those with a normal level of blood pressure.” Whelton is the lead author of the new AHA/ACC guidelines.

The impact of the new blood pressure guidelines is expected to be greatest for younger people. According to the AHA report, “The prevalence of high blood pressure is expected to triple among men under age 45, and double among women under 45.” 

The sudden rise of high blood pressure diagnosis, though startling, might be a good thing for population health. Earlier detection can prompt lifestyle changes that can prevent or manage high blood pressure.

Meet Beth

Beth is an example of someone who fits in the group of people whose blood pressure status changed under the new blood pressure guidelines. Beth is a 42-year-old mom. She works full time. When she feels stressed, Beth nibbles on dark chocolates that she stashed in her desk drawer. (It’s a health food, right?) And while Beth keeps close tabs on her aging parents, she doesn’t monitor her blood pressure. She assumed her blood pressure was OK. But when her nurse practitioner checked, it was 130/84. Beth has stage 1 high blood pressure.

White coat syndrome? Maybe. But Beth is overweight, inactive, and stressed. Her healthcare provider can teach Beth how to monitor her blood pressure at home, and help her adopt a heart-healthy lifestyle.

Stories like these make a strong case in support of the tougher blood pressure standards.

A Warning Sign

“We want to be straight with people – if you already have a doubling of risk, you need to know about it. It doesn’t mean you need medication, but it’s a yellow light that you need to be lowering your blood pressure, mainly with non-drug approaches,” says Whelton.

Lifestyle changes can help get blood pressure under control. But most people require more than take-home instructions to make a change. To choose the right approach, wellness providers can use evidence-based behavioral change models.

While there is no cure for high blood pressure, lifestyle changes greatly improve quality of life and help Beth control blood pressure levels. Using a health risk assessment that assesses readiness to change can help wellness professionals manage at-risk individuals within their population.

One Step at a Time

Beth is not interested in controlling her weight. But she is ready to manage stress better. And she’s thinking about improving her nutrition. There are many ways to relax, and Beth has chosen to take a walk with her family each evening after a healthy dinner. She also enjoys receiving healthy recipe tips from her health plan.

Beth represents the many participants who can make positive lifestyle changes in response to readiness-to-change linked to an elevated or high blood pressure diagnosis based on the new blood pressure guidelines.

Now that you know about Beth, check out what we learned about Norm from the March 2018 webinar.

There’s usually a good reason behind new rules. Whether updates in rules are made to keep people safer, or prevent them from being bored to tears at a four-hour baseball game, a lot of thought goes into shaking things up.


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“The prevalence of high blood pressure is expected to triple among men under age 45, and double among women under 45.” 

Paul Whelton, MD, MSc Tulane University