NEW HYPERTENSION GUIDELINES

Key Changes in the New Guidelines

• New targets for treatment: These recommend reductions in blood pressure to less than 130 mm Hg systolic and less than 80 mm Hg diastolic in most adults (down from 140/90 mm Hg).
• Earlier classification of hypertension: Adults with an average systolic pressure of 130 to 139 mm Hg or diastolic pressure of 80 to 89 mm Hg are now categorized as having stage 1 hypertension (these patients would have previously been considered as having "prehypertension").
• Atherosclerotic risk estimation to guide decisions in stage 1 hypertension: For patients at low atherosclerotic risk (10-year risk <10 advised.="" alone="" and="" are="" at="" changes="" diabetes="" disease="" drug="" for="" high="" including="" is="" kidney="" lifestyle="" p="" patients="" plus="" recommended="" risk="" therapy="" those="" whereas="" with="">
• New stage 2 classification: Patients with average systolic pressure higher than 140 mm Hg or diastolic above 90 mm Hg are now classified at stage 2 hypertension. As before, drug therapy is recommended for all these patients irrespective of atherosclerotic risk.
• Older patients: Older adults have the same treatment target as younger patients, and drug therapy is recommended for all older adults (age >65 years) with an average systolic pressure of 130 mm Hg or greater.
• Starting with two drugs: Most adults with blood pressure sufficiently elevated to warrant drug therapy should be treated initially with two agents, especially patients who are black or have stage 2 hypertension.
• More accurate estimation of blood pressure: Use average of measures taken over several visits, as well as out-of-office measurements.