Blood Pressure Archive

The new guidelines set a lower target and emphasize lifestyle changes. Here's why eating less salt is important.

High blood pressure — a major cause of heart attack and stroke — recently became far more prevalent in the United States, but not because people have become suddenly less healthy. Last fall, new guidelines lowered the threshold for diagnosing the condition, which used to be defined as a blood pressure reading of 140/90 millimeters of mercury (mm Hg) or higher. Now, anyone with a reading of 130/80 mm Hg or higher is considered to have high blood pressure (also known as hypertension). Nearly half of adults now fall into this group.

Many cardiologists welcomed the updated guidelines, published in the Nov. 7, 2017, Journal of the American College of Cardiology. "The new guidelines are based upon a growing body of evidence that lower blood pressure values are associated with fewer major adverse cardiovascular events, including heart attacks, strokes, and heart failure," says Dr. Randall Zusman, a hypertension expert at Harvard-affiliated Massachusetts General Hospital. Over all, people with Stage 1 hypertension (see "Blood pressure categories") have double the risk of those events compared with people who have normal blood pressure.

Research we're watching

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Adding a little extra spice to your food may help you eat less salt, according to a study in the December 2017 issue of Hypertension. A salty diet may raise your risk of high blood pressure, leaving you more prone to heart attack and stroke.

For the study, Chinese researchers recruited 606 people and determined their preferences for salty and spicy foods, in part by asking how often they ate foods such as salted fried pork and pickled Chinese cabbage.

Research we're watching

The pain relievers known as nonsteroidal anti-inflammatory drugs (NSAIDs) help ease the ache of arthritis. But taking these pills regularly can increase blood pressure and worsen heart disease. Now, new research suggests that topical NSAIDs (available by prescription in gel form) may pose less risk than the pills.

Researchers tracked heart attacks, strokes, and other heart-related problems in more than 46,000 people with rheumatoid arthritis over a nine-year period. People who used topical NSAIDs (even those who already had heart disease) had fewer of these cardiovascular events than those who took oral NSAIDs, according to the study, published in the Oct. 27, 2017, Journal of the American Heart Association.

These devices help you keep tabs on a key indicator of your cardiovascular health.

Of all the things you measure to assess your health, blood pressure certainly ranks among the most important. High blood pressure not only puts you at risk for a heart attack or a stroke, but also can damage your brain, eyes, and kidneys.

For some people with this common condition, checking blood pressure intermittently at the doctor's office may not be enough. Investing in a simple, inexpensive home blood pressure monitor often makes sense. It's especially helpful when you're starting a new medication or are taking several different ones and still working to reach your blood pressure goal.

Ask the doctor

Q. My doctor added metoprolol to the diuretic medication I'm taking for my high blood pressure. Ever since then, I've felt more tired than usual, and my wife says I seem a little depressed. Could the new drug be to blame, and if so, is there anything I can do about it?

A. Metoprolol (Lopressor, Toprol) belongs to a class of drugs known as beta blockers. These drugs — which make the heart beat slower and with less force — used to be given as a first-choice treatment for high blood pressure. But they can cause fatigue and depression in some people, as well as other side effects, such as erectile dysfunction.

Factors that harm your heart may be bad for your brain.

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During middle age, factors that leave you prone to a heart attack or stroke — high blood pressure, diabetes, and smoking — may raise your risk of developing dementia a quarter-century later, new research suggests. All three things affect your vascular (blood vessel) health.

The recent study, which adds to the growing evidence linking heart health to brain health, has elements that make findings especially reliable, says Dr. Gad Marshall, a Harvard Medical School assistant professor of neurology. "For understanding the vascular risks for dementia, this study is as close to definitive as we can get," he says.

Research we're watching

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Close to a third of Americans say they use artificial sweeteners on a daily basis. Popular examples include aspartame (Equal, Nutra­Sweet), sucralose (Splenda), and stevia (Truvia, Pure Via). They're all available in packets and are also added to soda, yogurt, and other foods.

But do these sugar substitutes actually help you lose weight? New research suggests they do not. In fact, these zero-calorie additives may have the opposite effect — and possibly even increase the risk of high blood pressure, diabetes, and heart disease.

Research we're watching

People who smoke marijuana may face a higher risk of dying of complications of high blood pressure than people who never use the drug, new research suggests.

The study included 1,213 people ages 20 and older who were part of a larger national health survey that began in 2005. Those who said they'd ever used marijuana (57%) were considered users. Researchers then looked at data on different causes of death in 2011 and estimated the association between marijuana use with death from high blood pressure, heart disease, and stroke.

As men live longer, more face the challenge of difficult-to-control high blood pressure.

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High blood pressure, or hypertension, remains a common health issue for a majority of older men.

In fact, approximately 54% to 67% of men ages 65 and older suffer from the condition, which occurs when your systolic pressure (the top number on a blood pressure reading) is 140 mm Hg or higher, and your diastolic pressure (the bottom number) is 90 mm Hg or higher, according to the American Heart Association.

Ask the doctors

Q. The July 2017 issue of Harvard Women's Health Watch spoke about the potential problems related to low blood pressure when taking blood pressure medication. My readings meet the definition of low blood pressure outlined in the article, but I don't take any medication. Should I be concerned, and if so, what should I do to raise my blood pressure?

A. In general, blood pressure is deemed too low only if it causes symptoms. A normal blood pressure is defined as a reading below 120/80 millimeters of mercury (mm Hg), and some experts consider your blood pressure low only if it dips below 90/60 mm Hg. However, a low reading can be normal for some people. Your doctor probably won't be too concerned about it unless it occurs suddenly; you have an underlying health condition that could cause low blood pressure, such as heart failure; or you are experiencing symptoms such as dizziness, lightheadedness, fainting, fatigue, or nausea. Some medications, such as diuretics (water pills), some antidepressants, and beta blockers, among others, can also cause low blood pressure. But since you aren't taking any medication, this is not an issue. If you are having symptoms related to your low blood pressure, this is something you definitely want to mention to your doctor. But if you've always had low blood pressure and you're not experiencing any problems, it's likely that this is normal for your body.