Under the new guidelines announced at an American Heart Association conference in Anaheim, California Monday 30 million Americans are added to those with high blood pressure.

That brings the total with the condition to half of U.S. adults.

High pressure for decades has been a reading on top of at least 140 or a bottom one of 90, under the new guidelines it drops to 130 over 80.

The changes add an additional 14 percent of U.S. adults to the ranks of people with the condition, but only two percent will need medication right away.

A dozen medical groups announced the advice.

They say poor diets, lack of exercise and other bad habits cause 90 percent of high blood pressure.

Currently only half of Americans with high blood pressure have it under control.

High blood pressure has been called the "silent killer,"  second only to smoking as a preventable cause of early death.

The upper threshold for high blood pressure has been 140 since 1993, but a major study two years ago found heart risks were much lower in people who aimed for 120.

Canada and Australia lowered their cutoff to that and Europe is still at 140 but is due to revise their guidelines next year.

The guidelines set new categories and get rid of "prehypertension":

  • Normal: Under 120 over 80
  • Elevated: Top number 120-129 and bottom less than 80
  • Stage 1: Top of 130-139 or bottom of 80-89
  • Stage 2:  Top of at least 140 or bottom at least 90

That means 46 percent of U.S. adults have high blood pressure versus 32 percent under the old levels.

The number will basically triple men under 45 to 30 percent, and double in women of that age to 19 percent.

For people over the age of 65, the guidelines undo a tweak made a few years ago to relax standards and not start medicines unless the top number was over 150.

Now everyone that old should be treated if the top number is over 130 unless they are too frail or have other health conditions that make it unwise medical authorities noted.

The guidelines were published in two medical journals, Hypertension and the Journal of the American College of Cardiology.

Blood pressure should be checked at least once a year by a health professional, and diagnosing high pressure requires two or three readings on at least two occasions.

Unlike adults, numbers for normal pressure in children vary with age, height and gender.  Kids should be checked at least once a year for high pressure according to guidelines announced in August by the American Academy of Pediatrics.

After age 13, the levels defining high pressure are the same as for adults.

The guidelines don't pick a method, but recommend measuring in the upper arm saying devices that work on fingers or are worn on wrists "aren't ready for prime time," home monitoring is also recommended.

Guidelines panel member Dr. Jackson Wright of the University of Cleveland Medical Center says, "The evidence is so solid, so convincing, that it's hard to argue with the targets.  Older people have a 35 to 50 fold higher risk of dying of a heart attack than younger people."

My Blood Donor Card. Photo by Gordy Kosfeld
My Blood Donor Card. Photo by Gordy Kosfeld

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