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Heart & Vascular Health
Hypertension medical poster design

New High Blood Pressure Treatment Guidelines

Changes are likely to raise questions, spark debate

The recommendations intended to guide how doctors in the United States treat millions of patients with high blood pressure are about to change in some surprising and potentially controversial ways.

No more pre-hypertension

The updated guidelines, released this morning by an expert scientific panel called the Joint National Commission (JNC), scrap the concept of “pre-hypertension,” the warning zone between 120/80 and 139/89 where patients previously had been advised to make blood pressure-lowering lifestyle changes.

The highly anticipated JNC report published in JAMA, the Journal of the American Medical Association, also does not define high blood pressure in the one-size-fits-all way that its predecessor report did. The previous JNC guidelines, issued a decade ago, classified hypertension as a blood pressure of 140/90 or higher in adults of all ages.

Age-based guidelines

The new guidelines are more nuanced, there is no blanket definition of hypertension. Instead, the JNC sets blood pressure thresholds, based on a patient’s age, beyond which drug treatment to lower blood pressure should begin. The tipping point for most people older than 60 to start medication  is 150/90.  Most people younger than 60 should begin anti-hypertensive drugs if their blood pressure is 140/90 or higher.

The report’s authors insist they have not re-defined hypertension, and they still assert the value of making diet, exercise and other lifestyle changes to lower high blood pressure and reduce medication needs. The JNC panel also noted that their recommendations shouldn’t trump a physician’s own clinical judgment. But the revised guidelines are certain to raise questions among patients and spark debate among doctors.

Cardiologists may aim lower

“The JNC is a very respected body and whatever they produce is going to command significant attention,” said Cleveland Clinic cardiologist Curtis Rimmerman, MD, who holds the Gus P. Karos Endowed Chair in Clinical Cardiovascular Medicine. “I have to respect their consensus opinion. But there are patients whose blood pressure you want to drive lower than 150/90. An example would be someone with a history of active congestive heart failure.”

“I’m going to continue to treat my patients like I’ve always treated them,” Dr. Rimmerman said. “And I think many cardiologists are going to feel the same way. That means aiming for a lower blood pressure goal than was suggested by this group. I personally think a normal blood pressure is 120/80 or less. As we get older, we liberalize that a little bit, and I don’t have a problem with that, given the increased potential for medication side effects.”

A major health issue

High blood pressure is a massive health concern in the United States, where nearly 78 million adults – or 1 in 3 people – have the condition. Half of those patients do not have their hypertension under control. High blood pressure is a major risk factor for stroke and heart disease.

The changes the JNC recommends are the result of a lengthy, rigorous review of hypertension research conducted since the last guidelines were issued a decade ago, in December 2003. Those clinical trials tracked how thousands of patients with high blood pressure fared in different situations, with varying treatments.

Answering critical questions

With those findings in hand, the JNC panel attempted to address three key questions:

  • Is there a threshold blood pressure at which beginning treatment with anti-hypertension drugs will clearly improve patients’ conditions?
  • Does lowering blood pressure with medications to a specific target level demonstrably improve patients’ medical outcome?
  • And finally, do different blood pressure-lowering drugs and drug types show clear differences in their impact on patients’ outcomes?

The answers, it turns out, are yes, yes and yes.

The clinical trials evidence showed a medical benefit from treating most hypertensive patients 60 and older to reach a blood pressure goal of less than 150/90.

For those younger than 60 with hypertension, the medical evidence supported using medication to drive diastolic pressure – the lower blood pressure number measured when the heart is resting between beats – below 90.

The research findings weren’t strong enough to dictate a systolic pressure target for hypertensive patients younger than 60. (Systolic pressure is the higher number that reflects the beating, pumping heart.) The JNC panel recommended that medications be used to get those younger patients below an overall pressure of 140/90.  

Differences in drug impacts

Regarding hypertension medications, the JNC panel’s review found moderate evidence to suggest that their effectiveness varies depending on patients’ racial group. The panel recommended that black hypertensive patients initially be treated with calcium channel blockers or thiazide-type diuretics; suggested drug regimens for non-blacks with high blood pressure include angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, calcium channel blockers or thiazide-type diuretics.

New targets may motivate patients

A possible benefit of the slightly relaxed 150/90 blood pressure ceiling for older patients, Dr. Rimmerman said, is that might encourage more of them to stick with therapy.

“Sometimes it takes up to four medications to get patients under reasonable control,” he said. “They’re taking 10, 12, 14 pills a day, especially considering their non-hypertensive medications. I think some of these people get very discouraged, and then when their blood pressure is not optimally controlled despite all these medications, they wonder if it’s doing any good. I wonder if the JNC is liberalizing this blood pressure goal with the idea that more patients are going to get on board and at least be treated to some degree.”

Tags: blood pressure, hypertension
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  • stericB.

    I know, my elderly Mom was having syncope(fainting) episodes at least 2x week. This would especially occur if she stood up from a chair a minutia too fast. We would give her BP meds regularly w/readings of 130/85,140/70 etc. These episodes stopped, after we took her off the BP meds and a couple other meds. She now also gets up out of the chair at a slower pace. These episodes were being caused by medically induced hypotension. Her current BP avg. is120-130/75-95.

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  • Sophia Blaze

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  • Stacey Lee

    thank God for the wonderful healing spell power which Dr.Eze.malaca render to my life which oracle support, i was been diagnosed with HIV-AIDS over 7years now which has lead me to unemployment and loosing my relationship with my fiance after he heard that i am suffering from the VIRUS, i tried begging him to allow me stays with him, but he still insist on letting me out of his home, until a friend of mine on Facebook from SOUTH AFRICA told me more about Dr.Eze.malaca the great healer, that he is going to help restore and healed my diseased with his powerful healing spell, she send me his address and i quickly contacted him, and he replied to after 30mins of my message that my disease is a little and minor disease, that he will solved the disease immediately only if i can accept all he requested from, i told him yes, because truly i know that ” HIV-AIDS IS A WICKED AND DEADLY DISEASE I EVER KNOWS “. so i did all he want from me and surprisingly on Friday last week Dr.Eze.Malaca called me that my problems is solved that i should hurry up to the hospital for a checkup, which i truly really did, i confirm from my doctor that i am now NEGATIVE AND NOT LONG +, I was still surprise and went to another place for the checkup,and it was still the same result that i am NEGATIVE.I jump up and was crying heavily because truly the disease drive a lot of things away from my life, my friends, my cousin, my fiance and relatives, but now since i was confirm NEGATIVE- my lost friends and fiance has been back to me begging for forgiveness, i have forgiven them and now we are now best of friend. again i will say to Dr.malaca that he is blessed and may the almighty God which i serve raise him and his family to the higher level in life. Thank and god bless. Please email Dr.eze.malaca for healing and solution now at Eze.malacaspelltemple@yahoo.com or contact his phone number +2348163395533 he will put a smile on you again

  • Bruno Rico

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    oracle fact and only to see that the following week Dr.Ero me on my mail box that my work is successfully done with his powers, i was firsts hocked and later arise to be the happiest woman on earth after i have concluded my final test on the hospital by my doctor that i am now HIV- Negative. My papers for check are with me and now i am happy and glad for his miraculous help and power. With these i must to everyone who might seek for any help, either for HIV cure or much more to contact him now at these following email now, Email: eromosalspiritualtemple@gmail.com

  • Bruno Rico

    I have been suffering from HIV/AIDS since 9yrs now, and i happen to have 2 kids for my husband, and now we cannot proceed to have another
    kids all because of my disease and now i have do all what a human like i and my husband can do just to get my disease healed, i have went to several places to seek for help not even one person could ever help, until i melt a comment on the daily news paper that was commented by Miss Marilyn about how this powerful traditional doctor help her get cured of the disease (HIV-AIDS) ” my fellow beloved” i firstly taught having a help from a spiritual traditional healer was a wrong idea, but i think of these, will i continue to stress on these disease all day when i have someone to help me save my life?” so i gather all my faiths and put in all interest to contact him through his Email address at eromosalspiritualtemple@gmail.com , so after i have mailed him of helping get my disease cured, i respond to me fast as possible that i should not be afraid, that he is a truthful and powerful doctor which i firstly claimed him to be. So after all set has been done,he promise me that i will be healed but on a condition that i provide him some items and obeyed all his oracle said. I did all by accepting his oracle fact and only to see that the following week Dr.Ero me on my mail box that my work is successfully done with his powers, i was firsts hocked and later arise to be the happiest woman on earth after i have concluded my final test on the hospital by my doctor that i am now HIV- Negative. My papers for check are with me and now i am happy and glad for his miraculous help and power. With these i must to everyone who might seek for any help, either for HIV cure or much more to contact him now at these following email now, Email: eromosalspiritualtemple@gmail.com

  • Mavin Kate

    MAVIN KATE

    Good day everyone,I AM FROM SOUTH AFRICA I have been suffering from HIV/Aids for over 4years now, and suddenly, i have spent all my money all to make sure i get healthy all day, but happily, last month may 12th 2014, I came in contact with a traditional doctor also known as a dr.Eze.malaca on a newspaper who is called Dr Eze.malaca who has help much people to cure their HIV and AIDS disease, firstly i taught it was a joke until i contacted him.and he said that if i am ready for this work, i told him yes, and he collected my details and told me that after he has finished consulting his oracle he will run back to me on when to go for a medical check up, i was unhealthy ling surprise. And truly last week Monday Dr Eze.malaca called me to quickly go for a medical check up, which I did, only to find out that I was not with any HIV disease anymore, my friends and families who left me before run back to me. I now found out that God in Heaven is using this man to bless and heal us all, he is a great and powerful man, again I say to you sir, that God Almighty will uplift you and your great work you did for I and other people. Please i will sincerely advice all HIV patient to contact this great powerful man called Dr.Eze.malaca for your solutions now at dr. Eze.malaca he will help you on your HIV problems…..email:(SPELLOFHEALINGCENTER@GMAIL.COM) or call doctor +2348163395533. He is the best spell caster to work with,i promise you that you will get your problems solved

  • Mavin Kate

    MAVIN KATE

    Good day everyone,I AM FROM SOUTH AFRICA I have been suffering from HIV/Aids for over 4years now, and suddenly, i have spent all my money all to make sure i get healthy all day, but happily, last month may 12th 2014, I came in contact with a traditional doctor also known as a dr.Eze.malaca on a newspaper who is called Dr Eze.malaca who has help much people to cure their HIV and AIDS disease, firstly i taught it was a joke until i contacted him.and he said that if i am ready for this work, i told him yes, and he collected my details and told me that after he has finished consulting his oracle he will run back to me on when to go for a medical check up, i was unhealthy ling surprise. And truly last week Monday Dr Eze.malaca called me to quickly go for a medical check up, which I did, only to find out that I was not with any HIV disease anymore, my friends and families who left me before run back to me. I now found out that God in Heaven is using this man to bless and heal us all, he is a great and powerful man, again I say to you sir, that God Almighty will uplift you and your great work you did for I and other people. Please i will sincerely advice all HIV patient to contact this great powerful man called Dr.Eze.malaca for your solutions now at dr. Eze.malaca he will help you on your HIV problems…..email:(SPELLOFHEALINGCENTER@GMAIL.COM) or call doctor +2348163395533. He is the best spell caster to work with,i promise you that you will get your problems solved..

  • John Park

    Good morning everyone, my name is Sandra from Pakistan, I have been

    suffering from

    HIV/Aids for over 4years now, and suddenly, i have spent all my money all

    to make sure

    i get healthy all day, but happily, last month January 12th 2013, I came in

    contact

    with a traditional doctor also known as a chief priest on a newspaper who

    is called Dr

    DRALABOKUN who has help much people to cure their aids disease, firstly i

    taught it was a

    joke until i contacted him ” ‘dralabokun@gmail.com

    ” and he said that if i am ready

    for this work, i told him yes, and he collected my details and told me that

    after he

    has finished consulting his oracle he will run back to me on when to go for

    a medical

    check up, i was unhealthy ling surprise. And truly last week Monday Dr

    alabokun called me

    to quickly go for a medical checkup, which I did, only to find out that I

    was not with

    any HIV disease anymore, my friends and families who left me before run

    back to me. I

    now found out that God in Heaven is using this man to bless and heal us

    all, he is a

    great and powerful man, again I say to you sir, that God Almighty will

    uplift you and

    your great work you did for I and other people. Please i will sincerely

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  • John Park

    Hello viewers all over the world I am Robert sandra, I want to testify
    of what DRALABOKUN do for me. i was having a very notorious and serious
    sickness called HIV i contacted these infection from my ex husband and
    was very in lost of hope i never believed i was going to be cured until i
    meant these great man called DRALABOKUN who God send to help me cure my
    sickness . just a few moment with these great man he cured my infection
    i want you to know that all hope is not lost until every thing is done
    if you also have these following infections contact these email DRALABOKUN@GMAIL.COM OR +2348071145063

    HIV/aids
    typhoid fever
    gonorrhea
    lancer fever.
    epilency.
    lung cancer.
    and
    also these man can also help you in giving you a very good help just
    give him a try and your problems will be solved just a contact with
    him.once again here is his email dralabokun@gmail.com. all call him +2348071145063 or thanks to dralabokun. Goodluck……….

  • Billioniers Clubs

    ALL THE VIEWERS AND READERS PLEASE FIND IT IN YOUR HEART TO FORGIVE ME,I KNOW I HAD DONE SO MANY WRONG THINGS AT PAST TIMES,I DON’T KNOW WHERE TO START WITH MY TESTIMONY..
    I AM VANESSA, i got married to a man [JEROME],who had a wife [JOSEPHINE] already,then i was made the second wife,and this JOSEPHINE has a daughter for my husband,called CHRISTABEL,JOSEPHINE was suffering from leg pain,that later took her life. so Christabel was left to live with me,and my two kids,PATIENCE AND GLORY,Christabel was the eldest of them, so i was misusing CHRISTABEL,SHE is the only one doing all the house work,anytime she dose some thing wrong,i wouldn’t give her food to eat all through the day,and beat her up with anything close to me,but she never worry,or insult me.or report to my husband.because i told her if she did i will kill her,i did this to some extent that,one day,she was on her menstruation period, she was afraid to tell me, she was not having enough cloth,so the only cloth she had she put it into her pant,so that, the cloth would soak the bleeding,and the cloth,i was the one that brought it for her,that the only cloth i ever brought for her,then the following morning i saw her cloth on the ground,with blood stain,i called her,and ask her what is this, she told me every thing, but i beat her up, and force the blood in the cloth into her mouth,i over heard her,as she was crying,cursing me,but never bother to listen to the word she was using,but now my two daughters and my son are yet to give birth,PATIENCE,GLORY AND EXCEL,AT their age[37,34 and 31]but they are married no children,i had gone to many places to know the cause of the problem,and CHRISTABEL WAS LIVING HAPPILY with her husband and four kids, three boys and a girl.i don’t know how my children,came to know about this HIOYA TEMPLE,when they got there, they told them i was the curse of their, problem,so one morning they all came home,and ask me what have i done to disturb their lives,the question sound,funny.i told them i had done nothing to hold their lives back,they cried me,down to this Hioya temple,i saw the man.he ask me what,did i do to some one,over 19 year ago,i forgot everything.i said nothing,HE EXPLAIN WHAT I DID TO ME,and this CHRISTABEL was helping my children with their needs and always come and pay me a visit and she always called me mummy,so this MAN HIOYA told me to go and apologize to her,once she accept the apology,then he will cast a pregnancy spell on my children,we all went to CHRISTABEL’S house and apologize,she forgives me,so they went back to the spell caster, for the pregnancy spell,TODAY PATIENCE CALL ME AND TOLD ME SHE IS PREGNANT,but I haven’t heard anything from the others,maybe they are still angry.with me that’s why they haven’t called me,..THANKS TO DOCTOR HIOYA FOR EVERY THING, IF YOU ARE FACINGS ANY PROBLEM,VISIT THIS GREAT HIOYA VIA [GREATHIOYATEMPLE@GMAIL.COM]]

  • John Park

    Hello viewers all over the world I am Robert sandra, I want to testify
    of what DRALABOKUN do for me. i was having a very notorious and serious
    sickness called HIV i contacted these infection from my ex husband and
    was very in lost of hope i never believed i was going to be cured until i
    meant these great man called DRALABOKUN who God send to help me cure my
    sickness . just a few moment with these great man he cured my infection
    i want you to know that all hope is not lost until every thing is done
    if you also have these following infections contact these email DRALABOKUN@GMAIL.COM OR +2348071145063

    HIV/aids
    typhoid fever
    gonorrhea
    lancer fever.
    epilency.
    lung cancer.
    and
    also these man can also help you in giving you a very good help just
    give him a try and your problems will be solved just a contact with
    him.once again here is his email dralabokun@gmail.com. all call him +2348071145063 or thanks to dralabokun. Goodluck……….

  • John Park

    Hello viewers all over the world I am Robert sandra, I want to testify
    of what DRALABOKUN do for me. i was having a very notorious and serious
    sickness called HIV i contacted these infection from my ex husband and
    was very in lost of hope i never believed i was going to be cured until i
    meant these great man called DRALABOKUN who God send to help me cure my
    sickness . just a few moment with these great man he cured my infection
    i want you to know that all hope is not lost until every thing is done
    if you also have these following infections contact these email DRALABOKUN@GMAIL.COM OR +2348071145063

    HIV/aids
    typhoid fever
    gonorrhea
    lancer fever.
    epilency.
    lung cancer.
    and
    also these man can also help you in giving you a very good help just
    give him a try and your problems will be solved just a contact with
    him.once again here is his email dralabokun@gmail.com. all call him +2348071145063 or thanks to dralabokun. Goodluck……….

  • Carolyn

    Hello

    Am Mrs Cindy Battye, from USA, Join me to celebrate for these great and perfect day which my lord god has done for using these great and powerful healing doctor called Dr.iayaryi to heal my sickness HIV/AIDS which has been chocking me up for over 3 years now without solutions, i have seek for solutions online, and through hospital, they keep on giving me orientations about drugs that can extend my years.now since Dr iayaryi has helped me to erased my disease out of my life, i we owe you greatly for healing me truly and to again, contact Dr iayaryi for HIV cure today, you can contact him through his phone +2348136923599 or his email address driayaryi2012@hotmail.com.

  • Carolyn

    Good day everyone, my name is LISA from CANADA, I have been suffering from HIV/Aids for over 4years now, and suddenly, i have spent all my money all to make sure i get healthy all day, but happily, last month JUNE 12th 2014, I came in contact with a traditional doctor also known as a Spell CASTER on a newspaper who is called Prophet Lord, who has help much people to cure their aids disease, firstly i taught it was a joke until i contacted himsolutionoflovespelltemple@gmail.com and he said that if i am ready for this work, i told him yes, and he collected my details and told me that after he has finished consulting his oracle he will email back to me on how it will be done and when to go for a medical check up, i was healthy surprise. And truly last week Monday Dr OKOLE called me to go for a medical checkup, which I did, only to find out that I was not with any HIV/AIDS disease anymore, my friends and families who left me before run back to me. I now found out that God in Heaven is using this man to bless and heal us all, he is a great and powerful man, again I say to you sir, that God Almighty will uplift you and your great work you did for I and other people. Please i will sincerely advice all HIV/AIDS patient to contact this great powerful man called Prophet Lord for your solutions now at solutionoflovespelltemple@gmail.com he will help you on your HIV/AIDS problems…..email: solutionoflovespelltemple@gmail.com

  • John Park

    Hello viewers all over the world I am Robert sandra, I want to testify
    of what DRALABOKUN do for me. i was having a very notorious and serious
    sickness called HIV i contacted these infection from my ex husband and
    was very in lost of hope i never believed i was going to be cured until i
    meant these great man called DRALABOKUN who God send to help me cure my
    sickness . just a few moment with these great man he cured my infection
    i want you to know that all hope is not lost until every thing is done
    if you also have these following infections contact these email DRALABOKUN@GMAIL.COM OR +2348071145063

    HIV/aids
    typhoid fever
    gonorrhea
    lancer fever.
    epilency.
    lung cancer.
    and
    also these man can also help you in giving you a very good help just /
    give him a try and your problems will be solved just a contact with
    him.once again here is his email dralabokun@gmail.com. all call him +2348071145063 or thanks to dralabokun. Goodluck……….

  • Helen Tolbert

    Dr. Ariba God will continue to bless you more abundantly, for the good works you are doing in peoples life, I will keep on writing and posting testimonies about you on the Internet, I’m Helen Tolbert, I was a HIV patient, I saw a blog on how Dr. Ariba cured someone, I contacted him and also got my healing, kindly email him now on dr.aribaspelltemple@outlook.com Or draribaspelltemple@gmail.com

  • Helen Tolbert

    Dr. Ariba God will continue to bless you more abundantly, for the good works you are doing in peoples life, I will keep on writing and posting testimonies about you on the Internet, I’m Helen Tolbert, I was a HIV patient, I saw a blog on how Dr. Ariba cured someone, I contacted him and also got my healing, kindly email him now on dr.aribaspelltemple@outlook.com Or draribaspelltemple@gmail.com…..

  • Helen Tolbert

    Dr. Ariba God will continue to bless you more abundantly, for the good works you are doing in peoples life, I will keep on writing and posting testimonies about you on the Internet, I’m Helen Tolbert, I was a HIV patient, I saw a blog on how Dr. Ariba cured someone, I contacted him and also got my healing, kindly email him now on dr.aribaspelltemple@outlook.com Or draribaspelltemple@gmail.com….

  • Helen Tolbert

    Dr. Ariba God will continue to bless you more abundantly, for the good works you are doing in peoples life, I will keep on writing and posting testimonies about you on the Internet, I’m Helen Tolbert, I was a HIV patient, I saw a blog on how Dr. Ariba cured someone, I contacted him and also got my healing, kindly email him now on dr.aribaspelltemple@outlook.com Or draribaspelltemple@gmail.com…..