The following are key points to remember from the 2017 Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults. Lower blood pressure target greatly reduces cardiovascular complications and deaths in older adults More intensive management of high blood pressure, below a commonly.
Nearly Half of U. S. Adults Have High Blood Pressure Under New Guidelines. Nearly half of all U. S. adults have high blood pressure, according to sweeping new guidelines released Monday that lower the threshold for who is considered at risk of complications from the condition. Most of the people considered newly hypertensive—largely younger Americans—would be urged to eat healthier and exercise more rather than take medicine, according to the guidelines, published by the American Heart Association and the American College of Cardiology...
Controlling High Blood Pressure. Keeping your blood pressure levels in a healthy range usually involves taking medications, reducing sodium in the diet, getting daily.
Guideline for High Blood Pressure in Adults. The following are key points to remember from the 2. Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Part 1: General Approach, Screening, and Follow- up.
The 2. 01. 7 guideline is an update of the “Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure” (JNC 7), published in 2. The 2. 01. 7 guideline is a comprehensive guideline incorporating new information from studies regarding blood pressure (BP)- related risk of cardiovascular disease (CVD), ambulatory BP monitoring (ABPM), home BP monitoring (HBPM), BP thresholds to initiate antihypertensive drug treatment, BP goals of treatment, strategies to improve hypertension treatment and control, and various other important issues. It is critical that health care providers follow the standards for accurate BP measurement. BP should be categorized as normal, elevated, or stages 1 or 2 hypertension to prevent and treat high BP. Normal BP is defined as < 1. Hg; elevated BP 1. Hg; hypertension stage 1 is 1.
Hg, and hypertension stage 2 is ≥1. Hg. Prior to labeling a person with hypertension, it is important to use an average based on ≥2 readings obtained on ≥2 occasions to estimate the individual’s level of BP.
Central Illustration: Updated Classification and Management of High Blood Pressure (BP) in Adults. Hypertension is the medical term for high blood pressure. Blood pressure refers to the pressure that blood applies to the inner walls of the arteries. Arteries carry. Normal Blood Pressure. Normal blood pressure for adults is defined as a systolic pressure below 120 mmHg and a diastolic pressure below 80 mmHg.
Out- of- office and self- monitoring of BP measurements are recommended to confirm the diagnosis of hypertension and for titration of BP- lowering medication, in conjunction with clinical interventions and telehealth counseling. Corresponding BPs based on site/methods are: office/clinic 1.
HBPM 1. 35/8. 5, daytime ABPM 1. ABPM 1. 20/7. 0, and 2. ABPM 1. 30/8. 0 mm Hg. In adults with an untreated systolic BP (SBP) > 1. Hg or diastolic BP (DBP) > 8. Hg, it is reasonable to screen for the presence of white coat hypertension using either daytime ABPM or HBPM prior to diagnosis of hypertension.
In adults with elevated office BP (1. ABPM or HBPM is reasonable.
For an adult 4. 5 years of age without hypertension, the 4. African Americans, 9. Hispanics, 8. 6% for whites, and 8. Chinese adults. In 2.
African Americans compared with whites. Often overlooked, the risk for CVD increases in a log- linear fashion; from SBP levels < 1. Hg to > 1. 80 mm Hg, and from DBP levels < 7.
Hg to > 1. 05 mm Hg. Statistics Adults Returning To College. A 2. 0 mm Hg higher SBP and 1.
Hg higher DBP are each associated with a doubling in the risk of death from stroke, heart disease, or other vascular disease. In persons ≥3. 0 years of age, higher SBP and DBP are associated with increased risk for CVD, angina, myocardial infarction (MI), heart failure (HF), stroke, peripheral arterial disease, and abdominal aortic aneurysm. SBP has consistently been associated with increased CVD risk after adjustment for, or within strata of, SBP; this is not true for DBP. It is important to screen for and manage other CVD risk factors in adults with hypertension: smoking, diabetes, dyslipidemia, excessive weight, low fitness, unhealthy diet, psychosocial stress, and sleep apnea. Basic testing for primary hypertension includes fasting blood glucose, complete blood cell count, lipids, basic metabolic panel, thyroid stimulating hormone, urinalysis, electrocardiogram with optional echocardiogram, uric acid, and urinary albumin- to- creatinine ratio. Screening for secondary causes of hypertension is necessary for new- onset or uncontrolled hypertension in adults including drug- resistant (≥3 drugs), abrupt onset, age < 3.
HF with preserved ejection fraction [HFp. EF] and HF with reserved EF [HFr.
EF], coronary artery disease [CAD], chronic kidney disease [CKD], peripheral artery disease, albuminuria) or for onset of diastolic hypertension in older adults or in the presence of unprovoked or excessive hypokalemia. Screening includes testing for CKD, renovascular disease, primary aldosteronism, obstructive sleep apnea, drug- induced hypertension (nonsteroidal anti- inflammatory drugs, steroids/androgens, decongestants, caffeine, monoamine oxidase inhibitors), and alcohol- induced hypertension. If more specific clinical characteristics are present, screening for uncommon causes of secondary hypertension is indicated (pheochromocytoma, Cushing’s syndrome, congenital adrenal hyperplasia, hypothyroidism, hyperthyroidism, and aortic coarctation). Physicians are advised to refer patients screening positive for these conditions to a clinician with specific expertise in the condition. Nonpharmacologic interventions to reduce BP include: weight loss for overweight or obese patients with a heart healthy diet, sodium restriction, and potassium supplementation within the diet; and increased physical activity with a structured exercise program. Men should be limited to no more than 2 and women no more than 1 standard alcohol drink(s) per day.
High Blood Pressure National Heart, Lung, and Blood Institute. Based on your diagnosis, health care providers develop treatment plans for high blood pressure that include lifelong lifestyle changes and medicines to control high blood pressure; lifestyle changes such as weight loss can be highly effective in treating high blood pressure. Treatment Plans. Health care providers work with you to develop a treatment plan based on whether you were diagnosed with primary or secondary high blood pressure and if there is a suspected or known cause. Treatment plans may evolve until blood pressure control is achieved. If your health care provider diagnoses you with secondary high blood pressure, he or she will work to treat the other condition or change the medicine suspected of causing your high blood pressure. If high blood pressure persists or is first diagnosed as primary high blood pressure, your treatment plan will include lifestyle changes. When lifestyle changes alone do not control or lower blood pressure, your health care provider may change or update your treatment plan by prescribing medicines to treat the disease.
Health care providers prescribe children and teens medicines at special doses that are safe and effective in children. If your health care provider prescribes medicines as a part of your treatment plan, keep up your healthy lifestyle habits. The combination of the medicines and the healthy lifestyle habits helps control and lower your high blood pressure.
Some people develop “resistant” or uncontrolled high blood pressure. This can happen when the medications they are taking do not work well for them or another medical condition is leading to uncontrolled blood pressure. Health care providers treat resistant or uncontrolled high blood pressure with an intensive treatment plan that can include a different set of blood pressure medications or other special treatments. To achieve the best control of your blood pressure, follow your treatment plan and take all medications as prescribed.
Following your prescribed treatment plan is important because it can prevent or delay complications that high blood pressure can cause and can lower your risk for other related problems. Healthy Lifestyle Changes. Healthy lifestyle habits can help you control high blood pressure. These habits include: Healthy eating. Being physically active. Maintaining a healthy weight.
Limiting alcohol intake. Managing and coping with stress. To help make lifelong lifestyle changes, try making one healthy lifestyle change at a time and add another change when you feel that you have successfully adopted the earlier changes. When you practice several healthy lifestyle habits, you are more likely to lower your blood pressure and maintain normal blood pressure readings. Healthy Eating. To help treat high blood pressure, health care providers recommend that you limit sodium and salt intake, increase potassium, and eat foods that are heart healthy.
Limiting Sodium and Salt. A low- sodium diet can help you manage your blood pressure. You should try to limit the amount of sodium that you eat.
This means choosing and preparing foods that are lower in salt and sodium. Try to use low- sodium and “no added salt” foods and seasonings at the table or while cooking. Food labels tell you what you need to know about choosing foods that are lower in sodium. Try to eat no more than 2,3. If you have high blood pressure, you may need to restrict your sodium intake even more. Your health care provider may recommend the Dietary Approaches to Stop Hypertension (DASH) eating plan if you have high blood pressure.
The DASH eating plan focuses on fruits, vegetables, whole grains, and other foods that are heart healthy and low in fat, cholesterol, and salt. The DASH eating plan is a good heart- healthy eating plan, even for those who don’t have high blood pressure. Read more about the DASH eating plan. Heart- Healthy Eating.
Your health care provider also may recommend heart- healthy eating, which should include: Whole grains. Fruits, such as apples, bananas, oranges, pears, and prunes. Vegetables, such as broccoli, cabbage, and carrots. Legumes, such as kidney beans, lentils, chick peas, black- eyed peas, and lima beans. Fat- free or low- fat dairy products, such as skim milk. Fish high in omega- 3 fatty acids, such as salmon, tuna, and trout, about twice a week. Adults Health And Wellbeing Directorate Tower Hamlets.
When following a heart- healthy diet, you should avoid eating: A lot of red meat. Palm and coconut oils. Sugary foods and beverages.
In the National Heart, Lung, and Blood Institute (NHLBI)- sponsored Hispanic Community Health Study/Study of Latinos, which studied Hispanics living in the United States, Cubans ate more sodium and Mexicans ate less sodium than other Hispanic groups in the study. All Hispanic Americans should follow these healthy eating recommendations even when cooking traditional Latino dishes. Try some of these popular Hispanic American heart- healthy recipes. Being Physically Active.
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