Exercise and other lifestyle changes are recommended first steps by the government before drug therapy for Americans whose blood pressure is too high but who have no other disease risk factors.
The new advice Thursday comes as the National Institutes of Health uncovers early signs that awareness and treatment of hypertension may be dropping after 25 years of improvements.Studies indicate that nearly half of hypertension patients go untreated and just 68 percent even know they have high blood pressure, numbers that have dropped slightly from 1991. Also troubling, the NIH said, is a small rise in the rate of strokes and a leveling off of deaths from heart disease.
In its new hypertension guidelines, the NIH's National Heart, Lung and Blood Institute recommends specific treatment approaches for patients depending on how good their overall health is.
Blood pressure of 140 over 90 is considered high.
Among the guidelines:
- People whose pressure is high, but not above 159 over 99, and who have no risk factors for heart disease or organ damage should try to lose at least 10 pounds, exercise regularly and reduce alcohol and salt consumption for a year before turning to medication. These patients once were told to try lifestyle changes for just three to six months before turning to medicine.
- If these patients smoke, have diabetes, are over 60 or have a family history of heart disease, they should try lifestyle changes for just six months.
- If these patients have cardiovascular disease or signs of organ damage, they should immediately be prescribed blood pressure medicine.
- People whose blood pressure is 160 over 100 or higher should take medication immediately, regardless of other risk factors.