Tuesday , June 28 2022

Ask your Doctors Styles of Life


Dear Doctor: What is a normal blood pressure for a person at the end of the '70s? My doctor said he should be in the 120/80 area. But I read that older people's pressure may be higher – closer to 140/90 – and that the pressure would not be dangerous. Am I the only one who was confused by the new rules of blood pressure?

Dear Reader: No, you are not alone struggling to understand the revised blood pressure guidelines. They were issued in November 2017 and since then we have received mail about them. Questions are not limited to the lay public. Due to several issues that we will be addressing at a later point, these stricter guidelines are also a continuous subject of discussion between health care providers. But let's start with the main question.

You are right that in the past, blood pressure targets for older adults were weaker. These allowed a slightly higher interval for normal blood pressure compared to younger adults. However, the new guidelines do not make the same allowances. As your doctor has explained, the American College of Cardiology and the American Heart Association are now defining the normal blood pressure for adults as lower than 120/80. If the peak number decreases between 120 and 129, even with a number of less than 80 or less, it is considered to be an increased blood pressure. Readings of 130/80 and above represent the threshold for several escalated blood pressure steps. At this time, these recommendations apply to all healthy adults, regardless of their age.

By some estimates, the updated guidelines shifted nearly half of all adults in the category of hypertension, practically overnight. Part of the thought behind the update was that discarding potential early hypertension would encourage patients and their physicians to discuss about the appropriate lifestyle changes. However, the rigor of new goals has caused quite little discussion and even discord.

The updated guidelines are based on the results of a study known as the Systolic Arterial Tension Intervention Trial or SPRINT. In the study, the participants rested quietly for five minutes before reading the blood pressure, which was taken with an automatic device. Three consecutive readings were then mediated to reach a final number. This is quite different from how blood pressure is usually measured in a physician's office that many health professionals have argued that the methodology had a statistically significant impact on the results. In addition, they ask your question, saying it is unreasonable to expect someone in the coming years to have the same blood pressure as someone 30 years old.

None of these changes the fact that hypertension is dangerous. Blood pressure that is uncontrolled raises the risk of serious health problems that include blood clots, stroke, kidney disease, heart disease and heart attack. Not only are the bigger the numbers, the higher the risks. Our advice is to discuss the issue with your primary care physician, who knows your general health, medical history and all the specific risks you face. He or she will help you set the blood pressure targets that are right for you.

Ask your questions at [email protected] or write: Ask your doctors, media relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA 90095.

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