new blood pressure guidelines

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COLUMBIA – New blood pressure guidelines mean nearly half of adults in the U.S. that did not have high blood pressure, will now be considered to have high blood pressure, according to Missouri Heart Center Cardiologist Dr. Mozow Zuidema.

The American Heart Association and American College of Cardiology released new joint guidelines stating 130/80 will now be considered stage one hypertension, instead of the old guideline of 140/90. 

Stage two hypertension is now 140/90. If blood pressure numbers are over 180/120, the patient will be considered in hypertensive crisis – this means they will need immediate treatment or hospitalization. 

Anything under 120/80 is still considered normal, but when blood pressure numbers rise above that they are considered elevated.

Zuidema said the guideline change was needed because early intervention with elevated or high blood pressure is important.


After looking at two sets of blood pressure numbers on two separate occasions, a doctor can make a diagnoses of elevated or high blood pressure.

Zuidema said the new guidelines mean a lot of younger people will fall into the category of elevated or high blood pressure, but the earlier a person acts on this the better for their overall health.

If a patient did not previously have elevated or high blood pressure, but does now, the first step would be looking at lifestyle changes, according to Zuidema. These changes include changes to a person’s exercise, diet, weight, stress, alcohol intake and stimulant use. 

Once a patient gets into stage one hypertension, or the lifestyle changes do not work, medication is considered. Other illnesses could also be screened for as a cause of the elevated or high blood pressure. 

“The trend that we will likely see is that more physicians or doctors will be prescribing more medication because we prescribe guidelines-based therapies,” Zuidema said.

Once a patient gets their blood pressure numbers down below 120/80, that will decrease complications overall from high blood pressure.


Zuidema said under these new guidelines, doctors are checking blood pressure a lot more to be sure the elevated or high blood pressure does not go unnoticed.

“If you have elevated blood pressure when you go into a doctor’s office, the guidelines specifically want us to look at that,” Zuidema said. “We’ve always called it white-coat hypertension.”

Zuidema said the new guidelines are stricter for doctors and require more check-ups for patients with hypertension – potentially as often as once a month. She said now cardiologists will look closer at those at-home numbers. This could require patients to get blood pressure monitoring equipment for the home.

“The more frequent we check our blood pressures, the more likely we will be able to determine if we do have elevated blood pressure and then make, initially, lifestyle changes,” Zuidema said.


The American Heart Association’s guidelines stated that a multi-ethnic study found the odds of developing hypertension over a person’s lifetime was higher for African Americans and Hispanics.

A study mentioned in the guidelines also found about 90 percent of adults who did not have hypertension at age 55 or 65 developed hypertension in their lifetime.

For adults age 45 without hypertension, the 40-year-risk for developing it ranged from 84 to 93 percent, depending on ethnic groups.

The American Heart Association said these estimates were based off of the old 140/90 guideline and would have been higher if the studies were done based off of the 130/80 guideline.