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New Blood Pressure Guidelines Highlight Need for Greater Awareness and Proactive Treatment


WEST ORANGE, NJ According to new guidelines issued in November by the American Heart Association and the American College of Cardiology, 46 percent of U.S. adults—about 103-million Americans—are now considered to be in the high blood pressure range. Under the previous guidelines, which had not been updated in over a decade, only 32 percent of U.S. adults (or 72 million Americans) were considered to be living with high blood pressure.

The new guidelines state that individuals who have a significant risk for cardiovascular disease or have established cardiovascular disease should be treated for high blood pressure, also known as hypertension, at a measurement of 130/80, as opposed to the previous standard of 140/90.

“High blood pressure is the second leading cause of preventable death in the United States, behind cigarette smoking,” said Gary J. Rogal, M.D., Chief of Cardiology for RWJBarnabas Health and cardiologist on staff at Saint Barnabas Medical Center. “Because high blood pressure has no symptoms, the only way to keep blood pressure in check is to have it accurately monitored regularly by your doctor. 

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“And while there are many factors that can contribute to high blood pressure—like obesity, inactivity, a high sodium diet, sleep apnea, stress and excessive alcohol intake—age, heredity and race can also contribute. These are all the more reasons to have blood pressure properly checked regularly.

“Accurately measuring blood pressure is your physician or health care provider’s job. It should be done at rest, in a sitting position and with at least three determinations. If you don’t measure blood pressure properly and it’s augmented for whatever reason, you’re going to make treatment errors.”

Blood pressure is a measure of the force with which your blood presses against your artery walls. The force is generated with each heartbeat as blood is pumped from the heart into the blood vessels. The two numbers recorded when measuring blood pressure are systolic pressure (the top number) and diastolic pressure (the bottom number).

Systolic pressure refers to the pressure inside the artery when the heart contracts and pumps blood through the body. Diastolic pressure refers to the pressure inside the artery when the heart is at rest and is filling with blood in preparation for the next beat.

In a healthy person, blood pressure is at an adequate level to keep blood flowing throughout the body without putting strain on blood vessel walls. In someone with high blood pressure there is increased tension on the blood vessel walls, which can cause a number of negative health effects.  

The newly released guidelines divide blood pressure readings into five categories, including:

  • Normal: 120/80
  • Elevated: A top number between 120 and 129, and a bottom number less than 80
  • Stage 1: 130-139/80-89
  • Stage 2: 140+/90+
  • Blood pressure greater than 160/100 requires prompt and aggressive treatment and follow-up

Depending on which category you fall into, high blood pressure can be treated effectively with medicines that can reduce the risk of complications in conjunction with simple lifestyle changes. Eating healthier, increasing exercise, limiting alcohol consumption, cutting out salt and losing weight are ways to lower blood pressure. It is also important to note the distinction between primary and secondary hypertension. The majority of people have primary hypertension. Primary hypertension has no clear cause. Secondary hypertension is when a physician has determined a reversible cause for hypertension.

“Understanding what blood pressure is, what the numbers mean, and what your own blood pressure is, is essential to improving and preserving your overall health and well-being,” said Rogal. “Patients must also understand that guidelines are the world of perfect medicine. They are written to be applied by your physician to you as an individual. And remember that blood pressure is not a static number.

“It’s important to follow blood pressure over time and get it properly measured regularly. These revised guidelines will hopefully encourage those with an elevated blood pressure to make healthier choices and to have their blood pressure checked routinely by their doctor to monitor the condition.”

RWJBarnabas Health's expansive network of cardiac services and facilities offers convenient access to consultation, testing, follow-up care, and rehabilitation. Our award-winning Heart Centers are nationally recognized and act as a model for today's most progressive cardiac programs, bringing together an extensive team of experienced heart specialists with a full complement of clinical resources.

Your heart doesn't beat just for you. Get it checked.  Visit for more information.

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