New hypertension guideline no cause for panic

Overseas Education | Lau Yuk-kong 13 Feb 2018

Lau Yuk-kong

the american college of Cardiology and the American Heart Association released the new guideline for hypertension in November.

Hypertension, or high blood pressure, is now defined as a reading of 130/80 mmHg, down from the previous reading of 140/90 mmHg.

Many are confused by the adjustment. What impacts will the new guideline bring? Should we be worried about the change?

The new hypertension guideline came about as a result of many studies over recent years.

The data revealed that hypertension, even with blood pressure greater than 130/80, led to a higher risk of cardiovascular diseases and stroke.

The change means a significant number of people who used to be in the category of pre-hypertension may now be diagnosed with hypertension.

There are currently around 800,000 hypertensive patients in Hong Kong based on the existing standard.

Under the new guideline, it is estimated that the number would rise to 900,000 to one million - a significant increase especially among the middle-aged and elderly population.

One need not panic or be overskeptical about the new scientific guideline.

Actually the guideline emphasizes the correct way of measuring blood pressure and that repeated measurements are needed, especially for cases involving borderline elevated blood pressure.

One positive result stemming from the stricter definition is that it helps alert patients already suffering from hypertension or are close to the margin.

It is hoped that they would be more proactive in taking preventive measures earlier on so as to lower the risk of complications, including strokes, heart failures, kidney failures and myocardial infarctions.

Those who may now be diagnosed with hypertension based on the new guidelines need not be anxious about needing medication immediately, as non-pharmacological measures are often suggested as the first line of treatment.

They can try taking on lifestyle modifications such as weight loss, regular exercise, reduction in salt intake and stress relief, all of which have been shown to be effective in controlling blood pressure.

And patients who are at high risk - with a history of diabetes, strokes, heart and kidney diseases - may be directed to start medication earlier on to achieve a tighter control.

All in all, we need not be unduly worried by the new guideline.

Whether Hong Kong would adopt the new definition of hypertension would require more discussion and considerations to decide if the rationale behind the new guideline is applicable and beneficial to our population.

In the meantime, we can all try to adopt a healthier lifestyle and keep our blood pressure in check.

Dr Lau Yuk-kong is a specialist in cardiology

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