People with slightly high blood pressure may need medication

By American Heart Association News

SDI Productions/E+, Getty Images
(SDI Productions/E+, Getty Images)

People with blood pressure that's a little too high should take medication to bring it down if lifestyle changes alone don't work, according to a new report.

The American Heart Association published the scientific statement Thursday in its journal Hypertension. It said doctors should consider prescribing blood pressure-lowering medication to people with stage 1 high blood pressure – a top number of 130-139 or a bottom number of 80-89 – who are unable to bring levels down after six months of lifestyle changes such as regular exercise and a healthy diet.

In 2017, the American College of Cardiology and American Heart Association issued blood pressure management guidelines recommending people with stage 1 hypertension and a low risk for heart attack or stroke within 10 years first try to lower their blood pressure with healthy lifestyle changes, then check levels again in six months. But the guidelines didn't say what to do if that strategy doesn't work.

The new guidance fills that gap. It would apply to nearly 10% of U.S. adults with high blood pressure.

The statement includes a range of healthy behaviors to lower blood pressure: achieving ideal body weight; exercising; eating less sodium, enhancing potassium intake and following Dietary Approaches to Stop Hypertension. Also called DASH, it includes fruits and vegetables, low-fat dairy products and less saturated fat and total fat. Other changes include limiting alcohol and not smoking.

"We know that people with blood pressure lower than 130/80 mmHg have fewer markers of cardiovascular risk like elevated coronary calcium, enlargement of the heart, or buildup of fatty deposits called atherosclerosis in arteries of the neck," Dr. Daniel W. Jones, chair of the statement writing group, said in a news release. He is professor and dean emeritus at the University of Mississippi School of Medicine in Jackson.

"There is strong evidence that treating high blood pressure saves lives by reducing the risks for heart attack and stroke," he said.

People working to lower blood pressure should check it regularly to monitor progress, Jones said. "If they don't achieve average daily systolic blood pressure less than 130 mmHg, it's probably time to initiate a conversation with their doctor about practical next steps, which may include adding medication, to manage their blood pressure."

The statement acknowledges that lowering blood pressure through lifestyle changes alone isn't easy.

"It is very hard in America and most industrialized countries to limit sodium sufficiently to lower blood pressure," Jones said. "And it is difficult for all of us to maintain a healthy weight in what I refer to as a toxic food environment. We want clinicians to advise patients to take healthy lifestyle changes seriously and do their best.

"We certainly prefer to achieve blood pressure goals without adding medication," he said. "However, successfully treating high blood pressure does extend both years and quality of life."

If you have questions or comments about this story, please email [email protected].

American Heart Association News Stories

American Heart Association News covers heart disease, stroke and related health issues. Not all views expressed in American Heart Association News stories reflect the official position of the American Heart Association. Statements, conclusions, accuracy and reliability of studies published in American Heart Association scientific journals or presented at American Heart Association scientific meetings are solely those of the study authors and do not necessarily reflect the American Heart Association’s official guidance, policies or positions.

Copyright is owned or held by the American Heart Association, Inc., and all rights are reserved. Permission is granted, at no cost and without need for further request, for individuals, media outlets, and non-commercial education and awareness efforts to link to, quote, excerpt from or reprint these stories in any medium as long as no text is altered and proper attribution is made to American Heart Association News.

Other uses, including educational products or services sold for profit, must comply with the American Heart Association’s Copyright Permission Guidelines. See full terms of use. These stories may not be used to promote or endorse a commercial product or service.

HEALTH CARE DISCLAIMER: This site and its services do not constitute the practice of medical advice, diagnosis or treatment. Always talk to your health care provider for diagnosis and treatment, including your specific medical needs. If you have or suspect that you have a medical problem or condition, please contact a qualified health care professional immediately. If you are in the United States and experiencing a medical emergency, call 911 or call for emergency medical help immediately.