The next time you visit your healthcare provider for a blood pressure check, you might notice a more aggressive approach towards managing high blood pressure. Recent guidelines from the American Heart Association (AHA) and the American College of Cardiology (ACC), released on Thursday, recommend that you consider abstaining from alcohol if you enjoy a glass of wine with dinner or a cocktail on weekends. This marks a significant shift in recommendations, as it is the first update since 2017, reflecting ongoing research aimed at providing the best strategies for managing high blood pressure.
Heart disease remains the leading cause of death worldwide, and controlling your blood pressure is one of the most effective ways to mitigate this risk. High blood pressure can also contribute to other serious health issues, including kidney disease, type 2 diabetes, and dementia. Alarmingly, nearly half of all adults in the United States are affected by elevated blood pressure levels. According to the new guidelines, the target blood pressure numbers remain unchanged: a normal reading is classified as less than 120/80 mm Hg, while elevated blood pressure is categorized as 120-129/80 mm Hg. If your blood pressure reads 130/80 mm Hg or higher, expect your healthcare provider to recommend significant changes.
Blood pressure is measured in millimeters of mercury (mm Hg) and consists of two readings: the systolic pressure (the upper number) and the diastolic pressure (the lower number). The systolic pressure assesses the force of blood as it is pumped from the heart into the arteries, while the diastolic pressure measures the pressure in the arteries when the heart is resting between beats. High blood pressure is often referred to as a "silent killer" because it typically presents no symptoms. However, elevated blood pressure can make your heart work harder, potentially damaging your arteries over time and increasing the risk of a heart attack or stroke.
The updated guidelines emphasize that if your systolic blood pressure is between 130 and 139, your healthcare provider should first recommend lifestyle changes. After a period of three to six months, if these changes do not bring your blood pressure into the target range, medication will be advised. This marks a shift from the 2017 recommendations, which suggested that anyone with a systolic reading above 140 should be prescribed both lifestyle modifications and medications.
Dr. Daniel Jones, chair of the AHA writing committee, stated, "We aim to control blood pressure more aggressively to better prevent cardiovascular diseases, strokes, kidney disease, and now we know that lowering blood pressure can also help reduce the risk of dementia." The lifestyle changes recommended include maintaining a healthy weight, adopting a heart-healthy diet, reducing dietary salt, managing stress, engaging in at least 150 minutes of moderate physical activity each week, and incorporating resistance exercises like weight training.
Another notable change from the previous guidelines is the recommendation to abstain from alcohol altogether. Previously, the guidelines suggested that women could have one drink or less per day, while men could have up to two. However, due to extensive evidence linking alcohol consumption to increased blood pressure, the current guidelines advocate for complete abstinence as the ideal choice. Dr. Jones emphasized that while many enjoy drinking, it is essential to make informed decisions based on these findings.
In light of new research regarding the challenges women face with high blood pressure during pregnancy, the updated guidelines stress the importance of monitoring blood pressure for those planning to conceive or who are already pregnant. High blood pressure during pregnancy can pose risks not only to the mother but also to the child, potentially leading to long-term health issues.
Recommendations for managing blood pressure include following the DASH diet, which emphasizes a diet rich in fruits, vegetables, whole grains, fish, poultry, beans, nuts, and healthy oils while keeping fats, sugars, and tropical oils to a minimum. Dr. Jones reiterated the importance of limiting sodium intake to less than 2,300 mg per day, with an ideal target of 1,500 mg per day. For individuals who are overweight or obese, losing at least 5% of body weight can significantly impact blood pressure levels.
For those with severe obesity, the guidelines recommend clinically proven interventions, including diet, exercise, and prescription weight loss medications. In cases of very severe obesity, surgical options may also be suggested. Dr. Jones acknowledged the challenges individuals face in managing their blood pressure but affirmed that making these dietary and lifestyle changes can lead to significant health improvements. "It’s hard, but it works," he said.
