The new guidelines stem from the 2017 results of the Systolic Blood Pressure Intervention Trial (SPRINT), which studied more than 9,000 adults ages 50 and older who had systolic blood pressure (the top number in a reading) of 130 mm Hg or higher and at least one risk factor for cardiovascular disease. The study's aim was to find out whether treating blood pressure to lower the systolic number to 120 mm Hg or less was superior to the standard target of 140 mm Hg or less. The results found that targeting a systolic pressure of no more than 120 mm Hg reduced the chance of heart attacks, heart failure, or stroke over a three-year period.
According to the American College of Cardiology and the American Heart Association, the goal of blood pressure treatment is to attain a blood pressure reading that's less than 130/80 mmHg systolic and less than 80mmHg diastolic. In general, if you have hypertension, it is likely that you will need to be treated for the duration of your life to maintain this target blood pressure. 
High blood pressure often runs in families. Much of the understanding of the body systems involved in high blood pressure has come from genetic studies. Research has identified many gene variations associated with small increases in the risk of developing high blood pressure. New research suggests that certain DNA changes during fetal development may also lead to the development of high blood pressure later in life.
These drugs block the effects of angiotensin, a chemical that causes the arteries to become narrow. Angiotensin needs a receptor- like a chemical "slot" to fit into or bind with- in order to constrict the blood vessel. ARBs block the receptors so the angiotensin fails to constrict the blood vessel. This means blood vessels stay open and blood pressure is reduced.

How can I stabilize my blood pressure? A wide range of factors influences blood pressure, including anxiety, stress, and medications. High blood pressure can have severe complications, such as a heart attack or stroke. A person can address fluctuating blood pressure with home remedies and lifestyle changes. Learn more about normalizing blood pressure here. Read now
Events in early life, such as low birth weight, maternal smoking, and lack of breastfeeding may be risk factors for adult essential hypertension, although the mechanisms linking these exposures to adult hypertension remain unclear.[43] An increased rate of high blood urea has been found in untreated people with hypertension in comparison with people with normal blood pressure, although it is uncertain whether the former plays a causal role or is subsidiary to poor kidney function.[44] Average blood pressure may be higher in the winter than in the summer.[45] Periodontal disease is also associated with high blood pressure.[46]
Everyone age 3 or older should have their blood pressure checked by a healthcare provider at least once a year. Your doctor will use a blood pressure test to see if you have consistently high blood pressure readings. Even small increases in systolic blood pressure can weaken and damage your blood vessels. Your doctor will recommend heart-healthy lifestyle changes to help control your blood pressure and prevent you from developing high blood pressure.
Enlarged heart. High blood pressure increases the amount of work for your heart. Like any heavily exercised muscle in your body, your heart grows bigger (enlarges) to handle the extra workload. The bigger your heart is, the more it demands oxygen-rich blood but the less able it is to maintain proper blood flow. As a result, you feel weak and tired and are not able to exercise or perform physical activities. Without treatment, your heart failure will only get worse.
The cuff is placed around the upper arm and inflated with an air pump to a pressure that blocks the flow of blood in the main artery that travels through the arm. The arm is held at the side of the body at the level of the heart, and the pressure of the cuff is gradually released. As the pressure decreases, a health practitioner listens with a stethoscope over the artery at the front of the elbow or an electronic machine senses the pulsation. The pressure at which the practitioner (or machine) first hears a pulsation from the artery is the systolic pressure (the top number). As the cuff pressure decreases further, the pressure at which the pulsation finally stops is the diastolic pressure (the bottom number).
High blood pressure is a common and dangerous condition. Having high blood pressure means the pressure of the blood in your blood vessels is higher than it should be. But you can take steps to control your blood pressure and lower your risk of heart disease and stroke. About 1 of 3 U.S. adults—or about 75 million people—have high blood pressure.1 Only about half (54%) of these people have their high blood pressure under control.1 Many youth are also being diagnosed with high blood pressure.2 This common condition increases the risk for heart disease and stroke, two of the leading causes of death for Americans.3 Get more quick facts about high blood pressure, or learn more about high blood pressure in the United States.
Essential hypertension is also greatly influenced by diet and lifestyle. The link between salt and high blood pressure is especially compelling. People living on the northern islands of Japan eat more salt per capita than anyone else in the world and have the highest incidence of essential hypertension. By contrast, people who add no salt to their food show virtually no traces of essential hypertension.
The drug of choice for hypertensive, pregnant women is one of the oldest high blood pressure medications on the market. Methyldopa, which works to lower blood pressure through the central nervous system, has the lowest risk of harming the mother and developing fetus. Other possible safe options include labetalol, beta blockers, and diuretics. Two classes of drugs which should never be used during pregnancy include the ACE inhibitors and the angiotensin II receptor blockers.
According to the Centers for Disease Control and Prevention (CDC), an estimated 75 million Americans have high blood pressure. Many risk factors for high blood pressure are out of your control, such as age, family history, gender, and race. But there are also factors you can control, such as exercise and diet. A diet that can help control blood pressure is rich in potassium, magnesium, and fiber and lower in sodium.

What you need to know about beta-blockers Beta-blockers are drugs that are used to slow down a person's heart rate. Doctors may prescribe them for a range of reasons, including angina and high blood pressure. There are many types and brands of beta-blockers, some of which affect other parts of the body. Learn about side effects, cautions, and interactions. Read now
NHLBI-funded Research Supports Development of Guidelines for High Blood Pressure Management. The Systolic Blood Pressure Intervention Trial (SPRINT) found that treating to a lower systolic blood pressure target—less than 120 mm Hg—reduced complications from high blood pressure and saved lives. SPRINT results informed recent high blood pressure clinical guidelines that aim to improve treatment for millions of people. SPRINT Memory and Cognition in Decreased Hypertension (SPRINT-MIND) is examining whether treating to the lower blood pressure target can reduce the rate of dementia and slow cognitive decline in the SPRINT participants.
High blood pressure can cause problems for a mother and her baby. High blood pressure can harm a mother’s kidneys and other organs and can cause early birth and low birth weight. If you are thinking about having a baby and have high blood pressure, talk with your doctors so you can take steps to lower or control your high blood pressure before and during the pregnancy. 

Hypertension is rarely accompanied by symptoms, and its identification is usually through screening, or when seeking healthcare for an unrelated problem. Some people with high blood pressure report headaches (particularly at the back of the head and in the morning), as well as lightheadedness, vertigo, tinnitus (buzzing or hissing in the ears), altered vision or fainting episodes.[20] These symptoms, however, might be related to associated anxiety rather than the high blood pressure itself.[21]
With age, comes an increased risk for systolic hypertension which can be aggravated by severe atherosclerosis. According to one study, the diuretic chlorthalidone (Hygroton) had significant benefit in elderly patients with systolic hypertension. Along with a diuretic, some calcium channel blockers, ACE inhibitors and angiotensin II receptor blockers may also be good choices. However, beta blockers may not be as effective for hypertension in those over 60; though they may be good choices if co-existing heart disease is present. It also may be preferable in elderly patients to give two high blood pressure medications at a low dose versus one at a higher dose.
If your blood pressure is always on the low side and you do not have any of the above symptoms, there is usually no cause for concern. Similarly, if you have a single at-home blood pressure reading that is abnormally low without any symptoms, you probably do not need to see your doctor. It is normal for your blood pressure to rise and fall over time, and your body is usually able to get your blood pressure back to normal.
In people aged 18 years or older hypertension is defined as either a systolic or a diastolic blood pressure measurement consistently higher than an accepted normal value (this is above 129 or 139 mmHg systolic, 89 mmHg diastolic depending on the guideline).[5][7] Other thresholds are used (135 mmHg systolic or 85 mmHg diastolic) if measurements are derived from 24-hour ambulatory or home monitoring.[79] Recent international hypertension guidelines have also created categories below the hypertensive range to indicate a continuum of risk with higher blood pressures in the normal range. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC7) published in 2003[27] uses the term prehypertension for blood pressure in the range 120–139 mmHg systolic or 80–89 mmHg diastolic, while European Society of Hypertension Guidelines (2007)[86] and British Hypertension Society (BHS) IV (2004)[87] use optimal, normal and high normal categories to subdivide pressures below 140 mmHg systolic and 90 mmHg diastolic. Hypertension is also sub-classified: JNC7 distinguishes hypertension stage I, hypertension stage II, and isolated systolic hypertension. Isolated systolic hypertension refers to elevated systolic pressure with normal diastolic pressure and is common in the elderly.[27] The ESH-ESC Guidelines (2007)[86] and BHS IV (2004)[87] additionally define a third stage (stage III hypertension) for people with systolic blood pressure exceeding 179 mmHg or a diastolic pressure over 109 mmHg. Hypertension is classified as "resistant" if medications do not reduce blood pressure to normal levels.[27] In November 2017, the American Heart Association and American College of Cardiology published a joint guideline which updates the recommendations of the JNC7 report.[88]
Instead of reaching for drugs, we should continue to find the most effective lifestyle interventions to help lower blood pressure and reduce cardiovascular risk without a laundry list of side effects. Unless, of course, you consider losing weight, having more energy, and feeling great as side effects — those are the type of side effects (from low-carb eating) that we all can embrace!
Some people may ask why doctors are lowering the threshold for high blood pressure, when it was already difficult for many patients to achieve the previous blood pressure targets of below 140 mm Hg/90 mm Hg, said Dr. Pamela B. Morris, a preventive cardiologist and chairwoman of the ACC's Prevention of Cardiovascular Disease Leadership Council. However, Morris said that the guidelines were changed because "we now have more precise estimates of the risk of [high] blood pressures," and these new guidelines really communicate that risk to patients. So, just because it's going to be difficult for people to achieve, "I don't think it's a reason not to communicate the risk to patients, and to empower them to make appropriate lifestyle modifications," Morris told Live Science.
The JAMA study was an extensive chart review of over 38,000 patients at low risk for heart disease who had stage two hypertension (blood pressure between 149/90 and 159/99) and were treated with blood pressure medications. Over an average follow-up time of almost six years, they found no reduction in the risk of cardiovascular disease events or risk of death with medication use. They did, however, find an increased risk for low blood pressure, fainting, and acute kidney injury among those treated with medications.
Note – always consult your personal doctor if you are unsure whether your numbers are too high or too low. If symptoms are present you need to visit your doctor promptly. Often times, an underlying problem may affect your numbers. It is always best to first try and change your lifestyle (abandon smoking, more exercise, proper diet) to mitigate the problem, however in some circumstances drugs will be your only option to keep things under control.
People with stage 1 hypertension who don't meet these criteria should be treated with lifestyle modifications. These include: starting the "DASH" diet, which is high in fruit, vegetables and fiber and low in saturated fat and sodium (less than 1,500 mg per day); exercising for at least 30 minutes a day, three times a week; and restricting alcohol intake to less than two drinks a day for men and one drink a day for women, said vice chairman of the new guidelines, Dr. Robert Carey, a professor of medicine and dean emeritus at the University of Virginia Health System School of Medicine. [6 Healthy Habits Dramatically Reduce Heart Disease Risk in Women]
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Much of the disease burden of high blood pressure is experienced by people who are not labeled as hypertensive.[87] Consequently, population strategies are required to reduce the consequences of high blood pressure and reduce the need for antihypertensive medications. Lifestyle changes are recommended to lower blood pressure, before starting medications. The 2004 British Hypertension Society guidelines[87] proposed lifestyle changes consistent with those outlined by the US National High BP Education Program in 2002[95] for the primary prevention of hypertension:
The reasons for this astonishing success are not yet entirely understood. Certainly, two of the major causes of high blood pressure are being addressed: excessive dietary salt is completely eliminated, and it is likely that some patients experience some reversal of the atherosclerosis process. However, Dr. Campbell has suggested that additional mechanisms may be partly responsible for fasting’s remarkable effects, such as the rapid reduction of a phenomenon known as “insulin resistance.”
Strong Heart Study. Since 1988, the NHLBI has supported the Strong Heart Study (SHS), the largest epidemiologic study of American Indians ever conducted. The SHS aims to estimate the impact of heart and blood vessel diseases and to assess how common and significant standard risk factors are in this community. Thirteen tribes and communities in four states participate in the study. Visit Strong Heart Study for more information.

You will work with your provider to come up with a treatment plan. It may include only the lifestyle changes. These changes, such as heart-healthy eating and exercise, can be very effective. But sometimes the changes do not control or lower your high blood pressure. Then you may need to take medicine. There are different types of blood pressure medicines. Some people need to take more than one type.
About 80 million Americans over age 20, 1 in 3 adults, have high blood pressure, and many don’t even know they have it. Not treating high blood pressure is dangerous. High blood pressure increases the risk of heart attack and stroke. You can live a healthier life if you treat and manage it! There are many ways to do so, taking natural remedies is just one of them.
Your doctor may diagnose you with high blood pressure when you have consistent systolic readings of 140 mm Hg or higher or diastolic readings of 90 mm Hg or higher. Based on research, your doctor may also consider you to have high blood pressure if you are an adult or child age 13 or older who has consistent systolic readings of 130 to 139 mm Hg or diastolic readings of 80 to 89 mm Hg and you have other cardiovascular risk factors.
In this article, we will describe the kinds of drugs that are used for hypertension, and what steps your doctor should take in choosing (from the incredible array of options) your optimal treatment. Finally, we will provide a reasonably complete list of all the drugs currently used in the U.S. (and in most developed countries) for the treatment of hypertension.
Hypertension is rarely accompanied by symptoms, and its identification is usually through screening, or when seeking healthcare for an unrelated problem. Some people with high blood pressure report headaches (particularly at the back of the head and in the morning), as well as lightheadedness, vertigo, tinnitus (buzzing or hissing in the ears), altered vision or fainting episodes.[20] These symptoms, however, might be related to associated anxiety rather than the high blood pressure itself.[21]

Hypertension is present in many people who are unaware they have this disorder. Hypertension is called a silent killer because too often the first symptom of the disease is a heart attack or stroke. To prevent this, get outside in nature and exercise, enjoy the flowers, and let nature provide a calming respite in life. Also, get regular medical checkups. If hypertension symptoms hypertension arise, seek immediate medical care. Call 911 immediately if someone has passed out unexpectedly.
When was the last time you thought about your blood pressure? If you're like most people, it probably hasn't been since your doctor mentioned it during your last checkup. But high blood pressure (hypertension) is a serious condition that can lead to life-threatening problems, like heart attack and stroke. The good news is that you can lower your risk of hypertension with lifestyle changes. 

The guidelines also say that a patient's blood pressure levels should be based on an average of two to three readings on at least two different occasions. It's also reasonable for doctors to screen for "white-coat hypertension," which occurs when blood pressure is elevated in a medical setting but not in everyday life, the authors said. This can be done by having patients measure their blood pressure at home. 
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