Redefining high blood pressure

New standards for hypertension could change your diagnosis.

measuring blood pressure
New standards for hypertension could change your diagnosis.

There’s a new threshold for how we define hypertension among Americans — and the numbers might surprise you.

For the past 14 years, the diagnosis of hypertension, or high blood pressure, was used for blood pressures over 140/90. The American Heart Association and the American College of Cardiology, however, have recently introduced new guidelines to improve blood pressure control and reduce the risk of cardiovascular disease.

These changes came about after studies showed a higher incidence of heart disease and strokes were due to hypertension.

Under these new standards, a normal blood pressure is considered 120/80 or lower, and hypertension is defined as readings greater than 130/80, versus the previous 140/90.

The change means that even more individuals, particularly seniors with other health conditions, will be diagnosed with hypertension. Some will receive recommendations for healthy lifestyle changes including dietary modifications and increased exercise. Others will also be pre-scribed medication to lower their pressure.

Here’s a look at the new hypertension categories and stages and what they’ll mean for all patients:

Having readings between 121–129/80 is considered an elevated blood pressure. In the past, an elevated blood pressure or pre-hypertension was considered 121–139/80–89. People with these readings will be instructed to adopt a series
of lifestyle changes.

Readings between 130–139/80–89 are now classified as Stage 1 hypertension. If your blood pressure is in this range, your physician will assess your 10-year risk for cardiovascular disease.

This risk is calculated using your age, weight, whether you’re smoker and/or if other health conditions are present such as high cholesterol or diabetes.

If your 10-year risk is less than 10 percent and you’re at Stage 1 hypertension, lifestyle changes will be recommended. If your risk is greater than 10 percent, medication will be prescribed to lower pressure. Normally, you’ll be reassessed after about a month.

Stage 2 hypertension begins at 140/90 or higher. At this level, it’s recommended to start lifestyle changes as well as blood pressure-lowering medication.

Individuals with readings higher than 180/120 will be classified as having a hypertensive crisis/emergency and will need to be evaluated and given prompt antihypertensive drug treatment.

There are several lifestyle modifications you can make to naturally lower your blood pressure. These include increasing exercise, losing weight, lowering salt in your diet, decreasing alcohol intake, quitting smoking and relieving stress. Always consult your primary care provider to develop a plan that works for you.

Heart disease continues to be the leading cause of death in Americans. One in three adults have high blood pressure and many of them (an estimated one-third) don’t know it.

By monitoring your blood pressure and getting it controlled at an early stage, you can improve your heart health and life outcomes.

Kira Snedden is a physician’s assistant at CVS MinuteClinic inside the Target store in Edina where blood-pressure monitoring and treatment services are provided. Find a clinic near you at