'High' Blood Pressure Gets Lowered

High blood pressure or hypertension is called the "silent killer," because it often has no symptoms. But it can significantly raise a person's risk of having a heart attack or stroke.

Dr. Aram Chobanian, of the National High Blood Pressure Education Program, visited The Early Show Thursday to discuss new guidelines that suggest many more Americans may be at risk of developing high blood pressure than had been previous thought.

The government says levels once considered normal or borderline actually signal "prehypertension," and those people must take care to stave off full-blown high blood pressure. The new category represents about 45 million people — meaning almost one-third of people with high blood pressure don't even know it.

Studies also found two-thirds of diagnosed patients of high blood pressure don't have the disease under control, because too often doctors hesitate to prescribe a second or third medication.

The National Heart, Lung and Blood Institute, which issued the new recommendations Wednesday, says the change comes from recent scientific studies showing the risk of heart disease begins at blood pressures lower than previously thought.

The guidelines were last updated in 1997 and a blood pressure level of slightly above 120 over 80 was previously thought to be in the safe range.

Chobanian says since then, studies have found even if you have a normal blood pressure at age 50, your risk of developing high blood pressure at one point in your life is about 90 percent. So what doctors want to do is catch those at risk earlier.

Complications from high blood pressure can begin with a blood pressure as low as 140 over 90.

The National High Blood Pressure Education Program recommends a person with prehypertension should undergo lifestyle changes, such as reducing body weight, exercising more, eating more fruits and vegetables and avoiding salty foods.

Also in the guidelines:

• Use Two Drugs For High Blood Pressure: Most people who already have high blood pressure will need at least two medications to get down to 140 over 90 or below. One drug will in most cases not do the trick.
• Use Diuretic For High Blood Pressure: For the majority of patients, one of those drugs should be a cheap, old-fashioned diuretic. The drug causes a person to urinate more and therefore get salt out of the body.
• Doctors need to treat hypertension more aggressively: Blood pressure is measured as two values and the first, or top, number in the reading is the most important for anyone over age 50 - something too few doctors and patients understand. If nothing else, that number should be below 140 over 90, says Chobanian.