New BP Guidelines Expand Hypertension Definition to 130 Systolic or Above

By Joe Elia

Edited by David G. Fairchild, MD, MPH, and Jaye Elizabeth Hefner, MD

New guidelines from the American College of Cardiology and American Heart Association, among others, define substantially more U.S. adults as having hypertension than the 2003 Joint National Committee (JNC 7) report's definition.

The new ACC/AHA guidelines — unveiled on Monday at the AHA's annual meeting — define systolic blood pressure at or above 130 mm Hg as constituting hypertension, while the older definition set the threshold at 140 or above. In addition, a diastolic BP of 80 or above is now considered hypertensive, versus 90 or above with JNC 7. On the basis of nationally representative data on roughly 10,000 adults, some 46% of Americans have hypertension under the new guidelines — versus 32% under JNC 7 — according to an analysis in the Journal of the American College of Cardiology.

Despite the expanded definition, the percentage of adults recommended to take drug therapy would rise modestly under the new guidelines — by about two percentage points over the JNC 7 recommendations.

Dr. Allan Brett explores the potential impact of the guidelines on clinical practice in NEJM Journal Watch General Medicine. See his analysis at the fourth link below.