New blood pressure guidelines
In newly published blood pressure guidelines,1 the American Heart Association, the American College of Cardiology, and nine other health organizations have agreed that high blood pressure, or hypertension, is now defined as 130 and higher for systolic blood pressure, or 80 and higher for diastolic blood pressure.
It is a major change from the old definition of 140/90 and higher, and the first update to U.S. guidelines on blood pressure detection and treatment since 2003.
“…definitely an improvement”
These new guidelines are definitely an improvement. As we have taught at the Pritikin Longevity Center for the last four decades, dramatic increases in heart attack and stroke risk do not begin with blood pressure readings of 140/90. They begin at much lower readings like 130/80.
In an American Heart Association news release, Paul K. Whelton, MD, lead author of the new guidelines, noted the dangers of blood pressure levels between 130-139/80-89:
“You’ve already doubled your risk of cardiovascular complications compared to those with a normal level of blood pressure. We want to be straight with people – if you already have a doubling of risk, you need to know about it. It doesn’t mean you need medication, but it’s a yellow light that you need to be lowering your blood pressure, mainly with non-drug approaches.”
The non-drug approaches recommended by Dr. Whelton and co-authors of the new guidelines are lifestyle-based, and include:
- Losing excess weight
- Launching a healthier diet, particularly one like the Pritikin Eating Plan that is plant-based and lowers sodium intake
- Exercising daily
- Drinking less alcohol
- Lowering stress
“Lifestyle changes as the first line of therapy”
“An important cornerstone of these new hypertension guidelines is a strong emphasis on lifestyle changes as the first line of therapy. There is an opportunity to reduce risk without necessarily imposing medications,” Richard Chazal, the immediate past president of the American College of Cardiology, told The Washington Post.
Since 1975 at the Pritikin Longevity Center, we’ve seen, every day, the power of healthy lifestyle changes to reduce blood pressure. The good news for many of our guests is that lowering of blood pressure to healthy, normal levels happens very quickly, often in a matter of days.
Consistently, studies have documented the blood-pressure-lowering benefits of a healthier lifestyle.
Below are research highlights:
- Seven studies have demonstrated that the Pritikin Program of eating, exercise, and lifestyle-change had quick and profound benefits for individuals with hypertension. Researchers from UCLA combined the data from all seven studies. This meta-analysis totaled 1,117 people with hypertension who had come to the Pritikin Center for an average of 3 weeks. Blood pressure was reduced to normal or near normal levels. Moreover, 55% of the 598 patients who were taking blood pressure medications eliminated their need for the medications, and the majority of the others had their dosages significantly reduced.2
- In a meta-analysis from Emory University of more than 23,000 participants, the authors compared several diets. They found that the one with the greatest reduction in blood pressure was DASH, or Dietary Approaches to Stop Hypertension. Like the Pritikin Progran, DASH is high in fruits, vegetables, and whole grains; moderate in nonfat dairy and lean meat, fish, and poultry; and low in sodium and fat. The magnitude of this diet’s blood pressure reductions, the authors wrote, “is similar to trials examining single drug therapies in mild hypertension,” indicating that this diet “may be an alternative to medication initiation in early stage hypertension.”3
- Scientists at the National Institutes of Health compared three different DASH diets. All were full of fruits, vegetables, and other whole foods, but they had varying amounts of sodium (3,300, 2,400, and 1,500 mg ). The researchers found that the biggest reductions in blood pressure occurred in those on the Pritikin-recommended 1,500 mg-a-day diet.4
Nearly half of U.S. adults now have high blood pressure
The new guidelines will sharply increase the number of people in America defined as having high blood pressure. With the previous cut-off of 140/90, roughly one in three U.S. adults had high blood pressure. The new guidelines will mean that nearly half of U.S. adults will be considered hypertensive.
However, point out the guidelines’ authors, there should only be a small increase in the number of people who will require anti-hypertensive medication. As mentioned earlier, scientists are emphasizing that lifestyle changes like improved diet should be the first line of defense.
It’s tough to change your lifestyle
“Those who have the resources to attend a healthy-living resort like the Pritikin Longevity Center do see dramatic reductions in their blood pressure, but unfortunately, diet and other lifestyle changes needed to reverse elevated blood pressure might be very difficult to achieve for others, especially if they cannot get expert dietary counseling to limit salt/sodium and make tasty foods using herbs and spices instead of added sodium,” laments Kimberly Gomer, MS, RD, Director of Nutritio at Pritikin.
“Getting expert dietary counseling in America can be a challenge because current U.S. medical guidelines often deny payment to registered dietitians/licensed nutritionists for management of hypertension. To really help most people lower their blood pressure with diet and lifestyle measures, we will likely need to establish treatment guidelines that allow physicians to refer their patients with high blood pressure to registered dietitians.”
- 1 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Executive Summary. A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines
- 2 Roberts CK, Barnard RJ. Effect of diet and exercise on chronic disease. J Appl Physiol. 2005; 98: 3-30.
- 3 Gay HC, Rao SG, et al. Effects of Different Dietary Interventions on Blood Pressure. Hypertension. 2016; https://doi.org/10.1161/HYPERTENSIONAHA.115.06853
- 4 Sacks FM, Svetkey LP, et al. Effects on Blood Pressure of Reduced Dietary Sodium and the Dietary Approaches to Stop Hypertension (DASH) Diet. N Engl J Med. 2001; 344: 3-10.