Blood pressure (BP) management is crucial for preventing heart disease, strokes, and other health issues. The American Heart Association (AHA) and American College of Cardiology (ACC) revised their BP guidelines in 2017, lowering the threshold for high blood pressure (hypertension) and emphasizing early intervention.

Blood Pressure Categories

Normal
- Systolic: <120 mmHg
- Diastolic: <80 mmHg

Elevated
- Systolic: 120–129 mmHg
- Diastolic: <80 mmHg

Stage 1 Hypertension
- Systolic: 130–139 mmHg
- Diastolic: 80–89 mmHg

Stage 2 Hypertension
- Systolic: ?140 mmHg
- Diastolic: ?90 mmHg

Hypertensive Crisis
- Systolic: >180 mmHg
- Diastolic: >120 mmHg

Key Points About Diagnosis and Treatment

• Single Readings Are Not Conclusive: Some patients may experience "white coat hypertension" (higher BP in a doctor’s office). Use a home blood pressure monitor to verify trends.
• Target BP Levels:
• Most healthy adults: <120/80 mmHg.
• Older adults (60+): <140/90 mmHg or slightly higher if frail or at risk of falls.
• Consider Context: Treatment plans vary based on age, cardiovascular risk, and overall health.

Lifestyle Changes for Stage 1 Hypertension

Medication may not be necessary if lifestyle adjustments effectively lower BP:

Adopt a Low-Sodium, Heart-Healthy Diet (like the DASH diet).

Increase Physical Activity: Aim for 150 minutes of moderate exercise per week.

Lose Excess Weight: Even small reductions in weight can lower BP.

Limit Alcohol Consumption.

Quit Smoking.

Medication Options

For severe or resistant hypertension, medications may include:
- Thiazide Diuretics: Chlorothiazide or hydrochlorothiazide, often first-line treatments.
- Combination Therapies: Low doses of multiple drugs may minimize side effects while effectively lowering BP.

Monitoring at Home

Regular at-home BP monitoring can enhance control and provide valuable feedback:

Use an Upper-Arm Cuff: More accurate than wrist or finger monitors.

Prepare Correctly: Avoid smoking, caffeine, or exercise 30 minutes before measuring.

Sit Properly: Back supported, feet flat, and arm at heart level.

Stay Still and Quiet: Talking can skew readings by up to 15 points.

Measure Consistently: Twice daily at the same times.

Summing it all up

Understanding and managing blood pressure can significantly reduce the risk of heart disease and other complications. Work with your doctor to define your target BP and adopt a personalized plan combining lifestyle changes and, if necessary, medication.

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