This additional monitoring can help to tease out masked hypertension (when the blood pressure is normal in our office, but high the rest of the time) or white coat hypertension (when the blood pressure is high in our office, but normal the rest of the time). The new guidelines also encourage additional monitoring, using a wearable digital monitor that continually takes blood pressure readings as you go about your life, or checked with your own cuff at home. New recommendations on monitoring blood pressure While we always knew this could result in a falsely elevated measurement, it is now officially poor clinical technique resulting in an invalid reading. My patients often have their first blood pressure taken immediately after they have rushed in through downtown traffic, as they're sipping a large caffeinated beverage. What does careful mean? The guidelines provide a six-step tutorial on how, exactly, to correctly measure a blood pressure, which, admittedly, is sorely needed. The measurements must have been obtained from at least two careful readings on at least two different occasions. Stage 2 high blood pressure is now over 140 systolic or 90 diastolic. Stage 1 high blood pressure (a diagnosis of hypertension) is now between 130 and 139 systolic or between 80 and 89 diastolic (the bottom number). That used to be a vague category called 'prehypertension.' Now, elevated blood pressure (without a diagnosis of hypertension) is systolic blood pressure (the top number) between 120 and 129.

(Please note that all numbers refer to mm Hg, or, millimeters of mercury.) The guidelines, in a nutshell, state that normal blood pressure is under 120/80, whereas up until Monday, normal was under 140/90. A new definition of high blood pressure (hypertension) However, a whole heck of a lot of people just got pulled into a significant medical diagnosis. Personally, I invite these stricter measures, because they are accompanied by solid research, logistical guidance, and useful management strategies. The definition of the diagnosis of high blood pressure and the decision-making process surrounding treatment have traditionally been quite individualized (read: all over the place). These organizations had piqued interest by declaring the release date and labeling it as 'highly anticipated.' I pooh-poohed all that drama, but upon reading through the 114-page executive summary PDF with 21 authors and almost a thousand references, I have to say, I am duly impressed. The American College of Cardiology and the American Heart Association certainly grabbed the attention of us busy primary care physicians with the recent release of their updated blood pressure guidelines.

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