The Half King Cafe

Suddenly, Half the Population Has High Blood Pressure?

In case you weren’t paying attention, 130 is the new 140. Before Monday, the threshold for high blood pressure was 140 over 90. Now the consensus is that it’s 130 over 80. Boom. Nearly half the population has hypertension. How’d that happen?

The Landmark SPRINT Study

Truthfully, this change didn’t happen overnight. The impetus to make this shift came from taking two years to digest the significance of a landmark study. SPRINT is one of those catchy study acronyms. It stands for Systolic blood PRessure INtervention Trial.

Two years ago, results from that study made a big splash in the New England Journal of Medicine. Investigators showed that targeting a systolic blood pressure of 120 or less yields fewer heart attacks, strokes and deaths, compared to a target of 140 or less.

Prior to that study, many experts in geriatrics fretted that treating hypertension more aggressively would lead to more complications. Older patients might experience more dehydration, dizziness, or falls. But SPRINT study painted a very different picture. With fewer strokes and heart attacks, people were more likely to keep living independently.

Other studies certainly play a role in supporting these new guidelines. But the SPRINT study is the linchpin.

Big News

Make no doubt about it, this is big news. It’s the first major change in the criteria for high blood pressure since 2003. It represents a consensus of ten diverse expert organizations. Consensus for such a big change is no small task. Thomas Frieden, former head of the CDC, explains why it’s such a big deal:

The big news about this guideline is it should end forever any debate about whether people should be treated with medicines once they hit 140/90. Until now there has been a perspective that it’s not that big of a risk, but that’s just wrong.

The fact is lower is better. Even what we considered mild hypertension before is a deadly disease.

Click here for the guidelines, here for more from the Washington Post and here for more from the New York Times.

The Half King Cafe, photograph © caren litherland / flickr

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November 15, 2017