New blood pressure guidelines may make millions anxious that they’re at risk of heart disease

Recent recommendations to lower the threshold for diagnosing patients with high blood pressure are likely to harm up to 80% of those newly diagnosed. Our analysis, published today in the journal JAMA Internal Medicine, argues the recommendations from two US bodies to diagnose people with a top blood pressure reading (systolic) of 130mmHg as having hypertension (high blood pressure) may do far more harm than good.

Previously, a person would be diagnosed as having hypertension if their systolic reading was 140mmHg or more. But late last year, the American College of Cardiology and the American Heart Association recommended lowering the threshold to 130mmHg.

High blood pressure is only one risk factor for heart disease and stroke. Other factors such as age, gender, smoking and diabetes also contribute to the overall risk profile. All of these must be considered together for a more accurate assessment of a person’s risk of heart disease and stroke.




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The recent recommendations will influence clinical practice worldwide – including in the UK and Australia. This could result in an additional 31 million people in the US, 6.7 million in the UK and 2.4 million Australians being told they have hypertension, implying they are at risk of heart disease and stroke. This may lead to anxiety over their future health and to treatment they might not need.

Why lower the threshold?

Prominent medical groups in the US have expressed concerns about the recommendations. The American College of Physicians said the stated benefits of reducing risk of heart disease and stroke were overestimated and harms underestimated. The American Academy for Family Physicians also raised concerns the harms of lowering the threshold were not assessed.

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