Dr Robert Carey Outlines the New Blood Pressure Classifications

The new hypertension guidelines made major changes to the classification of blood pressure, in general, and changed the name of one category to convey more importance, explained Robert Carey, MD, MACP, professor of medicine and dean emeritus at the University of Virginia.

What is the importance of the new blood pressure classifications in the hypertension guideline?
We’re very excited about this guideline, because we think it will improve the health of all Americans, and we have made some major changes since the last comprehensive guideline was published in 2003. That’s called JNC 7. We took over basically from the JNC 7 program, and now have a comprehensive guideline for 2017 and going forward.

The major changes are, first of all, we have revised the classification of hypertension, and blood pressure, in general. We have lowered the upper limit of blood pressure that we consider to be dangerous, and stage 1 hypertension, which used to be defined at 140 over 90 and now is defined at 130 over 80 and above—130 over 80 and 139 over 89 is stage 1 hypertension. And above that level, stage 2 hypertension is greater than or equal to 140 over 90, which is the old stage 1.

So, we’ve lowered those limits, we have eliminated the term prehypertension, because we really didn’t think it conveyed enough importance. We’re calling that elevated blood pressure, and that’s 120 to 129 over 80 to 89.

So, if you’re less than 120 over 80, you’re normal, and if you’re 120 to 129 over 80 to 89, you have an elevated blood pressure, but it’s still not hypertensive. Then, if you go above that to 130 over 80 to 139 over 89, that’s stage 1 hypertension. And that’s a new category compared to the 2003 guideline.
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