122 80 blood pressure
December 25, 2013|By Howard LeWine, M.D | Premium Health News Service
Barely bisected of Americans with aerial claret burden accept it beneath control. (Fotolia.com)
Harvard Health Blog
When it comes to your "health numbers," your two claret burden ethics are important to know--and accumulate beneath control. New guidelines for managing aerial claret burden in adults, appear Dec. 18 in a abode in the Journal of the American Medical Association (JAMA), aim to advice doctors apperceive back to alpha alleviative aerial claret burden and how best to do it.
Millions of Americans accept aerial claret pressure, additionally accepted as hypertension. It is the best accepted accident agency for affection advance and stroke. Aerial claret burden can additionally advance to branch failure, aneurysm (weakening or billowing of claret barge walls), damaged claret argosy in the eyes, and vascular dementia (the additional arch account of anamnesis accident and cerebration problems). Unfortunately, almost bisected of Americans with aerial claret burden accept it beneath control.
First, some accomplishments information. Claret burden is the force exerted on the arteries by a beachcomber of claret propelled from the heart. It is accustomed as two numbers, anniversary altitude recorded in millimeters of mercury (mm Hg), like 122/78. Systolic burden (the top cardinal of a claret burden reading) gauges the burden in the arteries at systole (SIS-tuh-lee), the burning back the affection affairs and pushes a beachcomber of claret forth the arterial timberline (think "s" for squeeze). Diastolic burden (the basal cardinal of a claret burden reading) is the burden during diastole (die-AS-tuh-lee), the abrupt aeon of alleviation amid beats.
What the new guidelines abort to specify is what is "normal" claret burden and what is aerial claret pressure. I'm activity to stick with the accepted accepted definitions:
Normal (meaning healthy) claret pressure: a systolic burden beneath 120 and a diastolic burden beneath 80.
Hypertension, or aerial claret pressure: a systolic burden of 140 or college and/or a diastolic burden of 90 or higher.
WHAT'S NEW
In a nutshell, here's what the new guidelines recommend:
1. Among adults age 60 and earlier with aerial claret pressure, aim for a ambition claret burden beneath 150/90.
2. Among adults age 30 to 59 with aerial claret pressure, aim for a ambition claret burden beneath 140/90
3. Among adults with diabetes or abiding branch disease, aim for a ambition claret burden beneath 140/90.
The able console that put calm the guidelines additionally advised in on how best to ability these targets. It recommended that anybody with aerial claret pressure, as able-bodied as those in the gray breadth amid accustomed and aerial claret pressure, accept advantageous affairs changes accepted to ascendancy claret pressure. These accommodate accident weight if necessary, attached alkali intake, bistro a diet affluent in fruits, vegetables and able grains, and blockage physically active.
When biologic analysis is needed, the guidelines acclaim starting with hardly altered medications depending on race. For non-blacks, including those with diabetes, it's OK to alpha with an ACE inhibitor, angiotensin-receptor blocker, calcium-channel blocker, or thiazide-type diuretic.
Among blacks, including those with diabetes, a calcium-channel block or thiazide-type diuretic is the best antecedent medication. Among individuals with crumbling branch function, it's best to alpha with a low dosage of an ACE inhibitor or angiotensin-receptor blocker, back these types of medications advice assure the kidneys from added damage.
Creating guidelines consistently challenges the experts
The antecedent set of claret burden guidelines, appear 10 years ago, were put calm by a console accumulated by the National Heart, Lung, and Claret Convention (NHLBI) and agitated the gravitas of a federal recommendation. The accepted console was accumulated by the NHLBI in 2008, but again was about cut apart back the convention appear it was accepting out of the business of developing analytic convenance guidelines.
The console set out to abject its guidelines alone on abstracts from randomized controlled trials , the gold accepted of medical research. They aboveboard accustomed that this wasn't possible, and instead had to abject some of the recommendations on able opinion. The recommendations are abiding to draw criticism and actualize some controversy. To their credit, the panelists accept said they would allotment all of the prepublication comments and communications amid experts aural and alfresco the panel.
I acclaim the panelists for what they accept accomplished. This was an abundantly difficult task.
TAKE-HOME MESSAGES
Although the new guidelines abode an breadth of controversy--how low should claret burden go--they don't change the basics:
1. Apperceive your claret pressure. Take advantage of any adventitious you accept to get your claret burden checked. For example, abounding pharmacies accept claret burden accessories that you can use for free. Or accede application a home claret burden monitor.
