New Guidelines Classify Nearly Half of America as Hypertensive

According to the new 2017 guidelines almost of America – 46% – are now considered to be in the high blood pressure category.  High blood pressure should now be treated at 130/80 rather than 140/90, according to the new parameters set forth by ACC/AHA.

One in three Americans had previously been diagnosed with the condition, but now 14% more Americans will be diagnosed with high blood pressure. The new guidelines will classify 103.3 million people as having high blood pressure, while the previous guidelines placed only 72.2 million Americans in this category, according to the authors of the report.

The authors, who include a panel of 21 scientists who reviewed more than 900 studies, believe the impact of their new guidelines will be greatest among younger and middle-age adults, with prevalence of high blood pressure expected to triple among men under 45 and double among women under 45.

The 2017 guideline is the successor to the “Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure” (JNC 7), published in 2003. The new ACC/AHA guidelines were developed with nine other health professional organizations and were written by a panel of 21 scientists and health experts who reviewed more than 900 published studies.

These new guidelines are comprehensive and incorporate new information from studies regarding blood pressure thresholds.  The recommendations set new parameters to initiate antihypertensive drug treatment, BP goals of treatment, strategies to improve hypertension treatment and control, and various other important issues.

The New Normal in Stages

It is critical that health care providers follow the standards for accurate BP measurement. BP should be categorized as normal, elevated, or stages 1 or 2 hypertension to prevent and treat high BP.

  • Normal BP is defined as <120/<80 mm Hg
  • Elevated BP 120-129/<80 mm Hg
  • Hypertension stage 1 is 130-139 or 80-89 mm Hg
  • Hypertension stage 2 is ≥140 or ≥90 mm Hg

The guidelines eliminate the category of prehypertension, categorizing patients as having either Elevated or Stage I hypertension

Prior to labeling a person with hypertension, it is important to use an average based on ≥2 readings obtained on ≥2 occasions to estimate the individual’s level of BP.  In addition, the guidelines stress the importance of using proper technique to measure blood pressure; recommend use of home blood pressure monitoring using validated devices; and highlight the value of appropriate training of health care providers to reveal “white-coat hypertension.”

In a corresponding analysis of the guidelines’ impact, Paul Muntner, PhD, et al., suggests “the 2017 ACC/AHA hypertension guideline has the potential to increase hypertension awareness, encourage lifestyle modification and focus antihypertensive medication initiation and intensification on US adults with high CVD risk.”


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