New Blood Pressure Guidelines
Blood pressure guidelines New Blood Pressure Guidelines
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 From the Publishers of the New England Journal of Medicine 

An unexpected increase in recent years of illness and death due to 
hypertension has prompted experts to urge more effective blood pressure control. The National Institutes of Health's new treatment 
guidelines reflect this urgency: They emphasize prevention for nonhypertensives, say more patients should reach the ideal blood 
pressure level of lower than 120/80 points, and give doctors a clearer map to follow in deciding each patient's treatment.  

Since the last guidelines, issued in 1992, research has shown that  people with blood pressure on the high side of normal or a family  history of hypertension—formerly not recommended for immediate treatment—can forestall hypertension through lifestyle changes. These 
 include losing weight for those overweight and regular 'erobic exercise for all. Salt, alcohol, and dietary fat should be limited, while fruits, vegetables, and low-fat dairy foods are needed for sufficient calcium, potassium, and magnesium. Quitting smoking doesn't directly affect blood pressure but greatly reduces the risk of stroke and heart disease.  

People already diagnosed with hypertension (140/90 points or higher) may also need a treatment update. For example, people with conditions such as diabetes in addition to hypertension should begin drug therapy immediately. By contrast, people with stage 1 
hypertension but no other risk factors may be able to try lifestyle modifications for longer than in the past. And specific drugs are now being recommended over others when patients have certain additional 
health conditions.  

If your blood pressure is under control and you have no other illnesses, you don't need to change your regimen, says Edward D. Frohlich, MD, editor of the journal Hypertension. But if you have other conditions in addition to hypertension, ask your doctor if you are 
receiving the most current treatment. And if your blood pressure is above the ideal, discuss treatments options with your physician.

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Recommended Treatments For
Stages of Hypertension
 
Blood Pressure
Stages (points)
Group A
(no risk factors)
Group B
(one or more risk factors*)
Group C
(certain 
conditions**)
High normal
(130-139/85-89)
Lifestyle
modification
Lifestyle
modification
Drug therapy
Stage 1
(140-159/90-99)
Lifestyle
modification
(up to 12 mos.)
Lifestyle
modification
(up to 6 mos.)
Drug therapy
Stages 2 and 3
(>160/>100)
Drug therapy
Drug therapy
Drug therapy
 
* Smoking, high cholesterol, age over 60, being male or postmenopausal female, or family history of heart disease 

** Diabetes, stroke, retinopathy, peripheral arterial disease, nephropathy, or clinical signs of heart disease 

Source: Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure