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New guideline on hypertension lowers threshold

December 01, 2017

By David Burger

Photo of Craig Ratner
Dr. Ratner
Nearly half of American adults are at risk for major health problems because of high blood pressure, according to a new scientific guideline issued by the American Heart Association that redefines this often silent but potentially harmful condition and provides tactics for health care providers to detect it.

People with readings of 130 as systolic or 80 as diastolic now are considered to have high blood pressure, according to the guideline released in November. High blood pressure used to be defined as 140/90.

The change means 46 percent of U.S. adults are identified as having high blood pressure, compared with 32 percent under the previous definition. A blood pressure of less than 120/80 still will be considered normal, but systolic pressure at or above 129 will be categorized as "elevated."

In addition to the lower threshold for hypertension, the new guidance includes recommendations for the way health care providers should take blood pressure measurements. The guidance recommends allowing patients to rest for five minutes prior to measuring their blood pressure and then to average at least two readings over two visits, indicating that a determination of whether a person has hypertension should not be made from a single blood pressure measurement. If the reading is above 130/80 on the first visit, patients should follow up with their primary health care provider.
 
"Undiagnosed or uncontrolled hypertension is a serious public health concern that affects nearly half of American adults according to a November scientific guideline issued by the American Heart Association," said Dr. Craig Ratner, chair of the ADA Council on Dental Practice. "Proper recognition and early treatment of this serious medical condition can help prolong the health and lives of our patients. The dentist's role in screening for hypertension, as part of a comprehensive evaluation and appropriate referral, is very important. Not only does proper screening allow for early detection and treatment, it may also provide oral health care providers an opportunity to educate their patients on the relationship of oral health and overall systemic health."

Screening for diabetes, high blood pressure and high cholesterol in the dental office could save the health care system up to $102.6 million each year, according to a 2014 study published by the ADA Health Policy Resources Center.