Taking blood pressure to new lows

The lower-is-better rule doesn't just apply to cholesterol.

Once upon a time, in a land not far away at all, a healthy blood pressure was thought to be 100 plus your age. That simple rule of thumb has gone the way of hats for men, cordiality in politics, and affordable health insurance. It was replaced in 1977 by a cutoff of 160/95 separating "normal" from high blood pressure. That cutoff continues to drift downward, steadily eroding what we think of as normal or healthy blood pressure.

National guidelines, published in 2003, took a range of blood pressures — 120/80 to 139/89 — that had been squarely in the normal camp and redefined them as prehypertension, or high blood pressure waiting to happen. Many people and their doctors thought that the hypertension experts got carried away. How does being labeled as having a "pre-disease" help anything, they wondered, especially when the guidelines didn't recommend any specific treatment for prehypertension beyond awareness and lifestyle changes?

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