New guidelines in the United States have lowered the threshold for high blood pressure (BP) to 130/80 from 140/90. It now puts almost half of all Americans – 46 percent – in the high BP category.
This gives people with BP of 130 over 80 a diagnosis of Stage 1 hypertension, according to the advice announced by the American Heart Association and 10 other healthcare organisations in US.
However, this doesn’t mean that all of these newly added people need medication right away; they should try healthier lifestyles, which get much stronger emphasis in the new advice.
It has sent ripples across the medical community but the doctors who led the guidelines panel said this new advice “is more honest”. But does it apply to Indians?
Should Indians Be Worried By This?
In India, hypertension in adults is defined with a blood pressure of 140/90.
However, the Association of Physicians of India and also the cardiologists The Quint spoke to say that the risk of cardiovascular events in Indians is higher at relatively lower levels of BP. But in the absence of definite data from India, we follow international guidelines.
If you have a BP with the upper level between 130-140, you should start being cautious and visit the doctor to rule out other high-risk factors. But medication would only begin on a case-to-case basis after a BP of 140/90.Dr Rajneesh Malhotra, Senior Director, Cardiac Surgery, Max Hospital Saket
Dr Rajneesh Malhotra, Senior Director, Cardiac Surgery, Max Hospital Saket, says that if India follows this new guideline, almost half of the population below 40-45 will come under the high BP category. The threshold of BP that is considered worrisome increases with age.
Hypertension is more dangerous when other risk factors are also there, and 130/80 is not a low threshold for Indians since incidence of diabetes and heart disease is even higher here, explains Dr Mukesh Goyal, Senior Cardiac Surgeon, Apollo Hospital.
130/80 is not a low threshold for Indians. Rather, anyone with that level should start taking precautions and follow a healthier lifestyle.Dr Mukesh Goyal, Apollo Hospital
They say that this is not a new norm and doctors have always cautioned people with these levels. Poor diets, lack of exercise and other bad habits cause 90 percent of high blood pressure.
The Need for India’s Own Standard of Healthcare Data
The upper threshold for high blood pressure has been 140 since 1993, but a major study in US two years ago found heart risks were much lower in people who aimed for 120.
Canada and Australia lowered their cutoff to that; Europe is still at 140 but is due to revise its guidance next year.
Experts say that there is a need for India to start collecting its own data and set its own standards since our environment and bodies are different than the western countries.
There is no comparative body in India, who’s researching and issuing these guidelines. Those non-governmental organisations whose guidelines are followed are also just looking at the western standards. There is a need to come up with our own data.Dr Sumit Ray, Senior Consultant, Sir Ganga Ram Hospital
The recent US guidelines set new categories and got rid of "prehypertension":
- Normal: Under 120/80
- Elevated: Top number 120-129 and bottom less than 80
- Stage 1: Top of 130-139 or bottom of 80-89
- Stage 2: Top at least 140 or bottom at least 90
This new advice doesn’t apply to Indians, but doctors say you should be cautious nonetheless.
(With inputs from AP.)
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