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




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Second, more people may experience negative effects from treatments to lower their blood pressure. Even though the new guidelines recommend non-drug interventions first for low-risk people, it seems likely many will be offered drugs to lower blood pressure if their reading remains above 130mmHg.

For example, the latest American College of Cardiology guide for clinicians says that although a person with low risk of heart disease should focus on lifestyle changes first, medication may be needed to achieve the goal of <130mmHg.

Third, in countries without universal health coverage, such as the US, people newly diagnosed with hypertension may face difficulties gaining insurance coverage for a “pre-existing” condition.

More people will be offered blood pressure medication that can lead to serious adverse effects.
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How to respond

So what should you and your doctor do in response to the new guidelines? First, you should have your risk of heart disease estimated using a reliable risk calculator (such as this one or this one or this one). This is more important for predicting your chance of a heart attack or stroke than just looking at your blood pressure.

If you are one of the many people who have a systolic blood pressure measurement that is 130-140mmHg, and are otherwise at low risk of heart disease, we believe doctors shouldn’t label you as having hypertension. Doctors should continue to support you to make healthy choices with regard to your diet and physical activity regardless of whether your systolic blood pressure is above or below 130mmHg.

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