New Recommendations To Prevent High Blood Pressure Issued; Additional Lifestyle Approaches Advised

Developed by a distinguished panel of experts convened by the NHBPEP Coordinating Committee, the advisory reflects the latest scientific evidence and updates the first recommendations on preventing high blood pressure released nearly a decade ago. Like the 1993 advisory, the new report emphasizes two overall strategies to keep blood pressure from rising: a population-based strategy and an intensive strategy for high-risk individuals. High blood pressure (systolic blood pressure at or above 140 mmHg or diastolic blood pressure at or above 90 mmHg) is associated with an increased risk of death and disability from heart disease, stroke, congestive heart failure, and end-stage renal disease.

"The United States has made substantial gains over the past several decades in preventing high blood pressure and in detecting and controlling high blood pressure when it does develop," said Dr. Claude Lenfant, director of the National Heart, Lung, and Blood Institute (NHLBI), which coordinates the NHBPEP. "However, Americans continue to be at high risk for hypertension and related complications. These revised recommendations can help us do better."

Fifty million adults in the United States -- including more than one of every two adults over the age of 60 -- have high blood pressure, according to the National Center for Health Statistics. Furthermore, data from NHLBI's landmark Framingham Heart Study suggest that middle-aged and elderly individuals face a 90 percent risk of developing hypertension during their remaining years.

Framingham research has also shown that the risk of cardiovascular disease associated with high blood pressure increases gradually - even before hypertension occurs. The approximately 23 million adults in the U.S. with high-normal blood pressure levels (systolic pressure of 130-139 mmHg and/or a diastolic pressure of 85-89 mmHg) are 1.5 to 2.5 times more likely to have a cardiovascular event or to die within 10 years, compared to those with optimal blood pressure (systolic pressure of less than 120 mmHg and diastolic pressure of less than 80 mmHg). Normal blood pressure levels are 120-129 mmHg systolic and 80-84 mmHg diastolic.

"Epidemiological data suggest that if we could lower the average systolic blood pressure among Americans by 5 mmHg, we'd see a 14 percent drop in deaths from stroke, a 9 percent drop in heart disease deaths, and a 7 percent drop in overall mortality," said Dr. Paul Whelton, senior vice president for health sciences for Tulane University Health Sciences Center and co-chair of the NHBPEP working group that developed the latest recommendations. "A reduction as small as 2 mmHg in the average American's systolic blood pressure could save more than 70,000 lives per year."

Proven behavioral changes can lower one's blood pressure and reduce the risk of a cardiovascular event. The report cites one study, for example, that found that people with normal blood pressure levels who increased the amount of regular physical activity lowered their systolic blood pressure by more than 4 mmHg. In another study, overweight participants with normal blood pressure levels significantly lowered their systolic blood pressure by losing weight (fewer than 8 lbs); in addition, the percentage of participants in this group who had high blood pressure seven years later was less than half of the percentage of the control group which remained overweight.

The clinical trial known as Dietary Approaches to Stop Hypertension, or DASH, has demonstrated the critical role of nutrition in controlling blood pressure. Based on the results of DASH, the NHBPEP now recommends an eating plan that is rich in fruits, vegetables, and low-fat dairy products and that has limited saturated and total fat.