In November of 2017, the American Heart Association (AHA) and the American College of Cardiology (ACC) presented new guidelines for the diagnosis and treatment of hypertension.
The new diagnosis of hypertension, or high blood pressure, is now established at lower numbers. As a result of these new guidelines, 46% of the adult US population will have “high blood pressure.” The number of young men under age 45 with a diagnosis of high blood pressure will triple, and will double for young women.
The new guidelines state that normal blood pressure is less than 120/80 mm Hg. Stage 1 hypertension is systolic 130-139 or diastolic between 80-89. The previous consensus guidelines defined Stage 1 as systolic 140-149 or diastolic 90-99.
On December 12, 2017, the American Academy of Family Physicians (AAFP), my parent organization, decided against endorsing the AHA/ACC hypertension guidelines. They decided to stay with JNC-8, the “2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults.”
What should we do in the corporate wellness community? On the front lines of health promotion, we are very aware of the epidemic of unhealthy lifestyles. Obesity, sedentary lifestyles, and smoking are contributing to high levels of diabetes, hypertension, and heart disease. It is not a shock that half of adults will be labeled as having high blood pressure with these new guidelines.
After careful consideration, Provant has elected to endorse and embrace the new ACC/AHA guidelines.
We feel strongly that addressing elevated blood pressures with lifestyle advice, and engaging with more individuals at an earlier stage, is beneficial to the health of individuals and society. We are advising positive lifestyle changes: increasing activity, healthy eating, decreasing stress. This is good not just for cardiovascular health, but for all other aspects of well-being, including emotional health. There is nothing controversial about advising on healthy habits earlier in life.
The greatest controversy in the new guidelines is the lack of attention to the negative side of aggressive treatment with medications to a lower blood pressure farther than previously. The potential side effects of the medications and the effect of blood pressure that is too low are real. However, we avoid that controversy by not being involved in the pharmaceutical aspect of treatment for high blood pressure.
Positive interaction with patients and employees regarding healthy living is beneficial to overall health. The new blood pressure guideline increases the opportunities and challenges for cardiovascular health promotion. Lower blood pressure numbers, obtained through positive lifestyle changes, will improve individual health and wellness.
David Ashley, MD
Chief Medical Officer