Changing Definitions of Hypertension From 1990 - 2010

©2010, Patty Inglish, MS Preventive Medicine. 

Some of us have been frustrated by changes, fine tuning - even hair splitting - concerning the defiinition of high blood pressure or hypertension. Further, no matter what the definition, many people have the condition without knowing they have it and many that do know do not comply with measures that can lower the numbers and the risks for heart attack and stroke, e.g. diet, exercise, stress management, stopping smoking, reducing alcohol intake, individual factors, etc., etc. To the health practitioner dealing with blood pressure and cardiovascular risk factors, the total landscape makes a Gordian Knot.

One critical consideration is that there exists a condition known as Uncontrollable High Blood Pressure. No medication, no technique, nothing works on it. A group of Ohio physicians in the mid-1990s felt that they would like to construct a blood pressure clinic on the Moon for these cases, the reduced gravity felt to probably reduce the blood pressures. It is an interesting notion.

I have heard various schools of thought regarding Hypertension or High Blood Pressure in our universities and clinics. One such thought was that perhaps the blood pressures of senior citizens increase with age, because they are supposed to do so, naturally. Today, many articles report that average blood pressure raises with age, but the numbers can be lowered with preventive measures, especially if taken up in earlier life. But how high is high?

While some useful information exists here and in official website data from the National Institutes of Health, the American Heart Association, the Red Cross, and other organizations, I think it is important that you be working with a licensed healthcare or a well-trained and knowledgeable alternative health practitioner in order to determine the healthiest blood pressure levels for your individual Self. The same may be stated for other vital signs and other biological/health readings. I can't point from the Internet and say "so-and-so has high blood pressure." However, some physicians are beginning to consult with some patients over the Internet. In the future, we can probably send many of our vital signs over the web. 

Even after studying and working with blood pressure risk prevention and treatment, I want to consider individual differences in people as well as national guidelines, so I advise people to ask their healthcare providers about their own readings and not to really 100% on tables of guidelines. Guidelines change, new information emerges every day, and we may not have immediate access to it all, even with the Internet running 24/7. New journal articles are sometimes available only at a high fee, for example. I read MayoClinic.com regularly for new information - it's where I found that blood pressure is generally higher in winter than summer.

America seems to be entering an age of Mars exploration and colonization, and privatized space flight and we know that the guidelines for blood pressure may change "out there."For instance - how many G Forces can one tolerate and how does this change per every decade or year of aging? This is useful information for roller coaster riding on earth as well - some coaster operators worn riders about high blood pressure. People living in extraterrestrial colonies in a gravity of less magnitude than Earth's will likely experience lower blood pressure. But then, how low is low? I still have a vision of people living in space without artificial gravity as turning into jellyfish as calcium leeches from bones and muscles lose mass and tone. Newer preventive medicine and public health projects and NASA researchers and physicians are looking into that; private enterprises are likely up to the same activities.

Is the truth out there as X-Files told us? Maybe.

After several years of quoting "120/80" as normal blood pressure, we were told in the 1990s that we were incorrect. Ooops. We in educational, public health, and clinic type settings began to be directed that the reading 120/80 was the lower limit of pre-hypertension. In fact, 119/79 was "high normal." It was all frustrating, but, with an average blood pressure of 110/70, I was not going to worry about my own; and I checked it a few times a week. I felt I had to be very careful about what I told clients and test participants so as not to be alarmist.

We were taught about blood pressure's staus as a "continuous variable" - meaning that you can't stop the blood pressure in order to measure it (we laughed). So, we began taking our own readings daily and looking at trends.

I still check my blood pressure reading 2-4 times a week at the drug store at the pharmacy counter where a kiosk sits quipped with a seat and an automatic cuff. These setups are not 100% accurate, but are good for a general screening. They are not very accurate for the individuals that need a larger cuff because of arm diameter, for example. I like the screenings available through a LifeLine or similar mobile clinic where the staffers take pressure readings in both arms and both lower legs. Many people have the screening yearly and it includes other helpful measures as well.

Overall, if either my systolic or diastolic pressures land in the prehypertensive range, I take a closer look at my daily diet, activities, and stress levels. When visiting a healthcare professional, I take the last two readings with me.

Many churches and other organizations provide free screenings for blood pressure and cholesterol and these are a good first measure to determine if a client needs further workups. I remember that in the 1990s, Japanese airports offered cholesterol reading machines. Screenings may become increasingly more accessible and easy with time forward.

EXAMPLES

140/70 = Stage 1 Hypertension

110/99 - Stage 1 Hypertension

100/100 = Stage 2 Hypertension

140/100 = Stage 2 Hypertension

170/75 = Stage 2 Hypertension

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A single reading with a high number is not a final diagnosis of High Blood Pressure. Take more than one reading, compare, and consult with your healthcare practitioner!