New Standards for Diagnosing Hypertension Are Met with Skepticism

By Kathryn Romanchuk, Janine Bahsali, and Emily Burnett, Guest Writers; photos by Richard Frederickson, Staff Photographer
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Mercy Gathuka, Occupational Health Services, prepares to take a blood pressure reading from Alma Fout, Environment, Health, and Safety.

Members of the Eighth Joint National Committee recently released new standards for treating hypertension, also referred to as high blood pressure (BP). The new standards do not recommend treatment changes for individuals under 60 years of age. However, treatment changes were recommended for people over the age of 60 who do not have conditions such as diabetes or chronic kidney disease (CKD), but whose BP numbers are 150/90 or higher. This BP threshold is up from the previously recommended threshold of 140/90. The panel also recommended that for people over 60 years of age who have diabetes or CKD, treatment should begin when BP is 140/90, which is an increase from 130/80. Treatment may involve lifestyle changes and/or medication to bring the BP numbers into a healthy range.

The proposed standards have been met with some skepticism from certain health care–oriented organizations. The American Heart Association’s (AHA’s) website recommends initiating treatment for patients with hypertension at 140/90 up until 80 years of age, as opposed to beginning treatment at 150/90 for patients over the age of 60, as the new standards suggest. Hypertension is a common condition in which there is long-term pressure against the arterial walls that leads to health problems. There are many ways to treat hypertension, such as better nutrition and exercise, and medications including diuretics and beta blockers.

“We believe there’s just not enough evidence at this point to justify such a major change in how we treat people with high blood pressure,” said former AHA president Mariell Jessup, M.D., on AHA’s website.

Know Your Numbers

A BP score is made up of two numbers: the first number represents the systolic pressure, which is the pressure in the arteries when the heart beats. The second number represents the diastolic pressure, or the pressure in the arteries between heart beats. The revised standards are a result of experts having a better understanding of the effects that age and medical conditions have on BP. A study of patients between the ages of 30 and 69, who received medications to lower their diastolic BP, demonstrated reduced cerebrovascular events, heart failure, and risk of mortality. These results encouraged the idea that controlling diastolic BP is essential to the treatment of hypertension. The proposed standards target patients over 60 years of age who do not have pre-existing medical conditions. Following the new standards, those patients with mild hypertension may be able to stop taking their blood pressure medication.

Sarah Hooper, manager of Occupational Health Services (OHS), said the health of the employees at NCI at Frederick is important to OHS, and OHS staff wants to empower the community to stay informed.

“When it comes to your health numbers, your two BP values are important to know,” Hooper said. “The revised BP guidelines aim to assist health care providers in identifying when to start treating high BP and how best to do it. We encourage you to review it and partner with your doctor to discuss it.”

Several factors that affect BP remain uncontrollable, including age, gender, ethnicity/race, and family history. However, there are factors that can be controlled, such as personal lifestyle, weight, amount of exercise, diet, stress, and smoking, along with medical conditions and medications.

For more information on blood pressure guidelines or to have your blood pressure checked, call OHS at 301-846-1096 or attend one of the blood pressure clinics held on Tuesdays and Thursdays from 12:30 to 1 p.m. at OHS, Building 426.

Kathryn Romanchuk and Janine Bahsali are Cancer Research Training Award program students in Occupational Health Services. Emily Burnett is a Werner H. Kirsten student intern in Occupational Health Services.