PhotoWhile not exactly controversial, what your blood pressure should be has become a topic of debate within the medical community.

It started in 2013, when an American Medical Association panel on hypertension issued new guidelines, suggesting patients over 60 were fine with a blood pressure reading of 150/90. Blood pressure goals were also eased for adults with diabetes and kidney disease.

The following March researchers at Duke University ran an analysis and determined that an estimated 5.8 million adults no longer needed blood pressure medicine under the new guidelines.

Since then, opposing views advocating the lower 120/80 blood pressure benchmark have been heard loud and clear. The latest is a new study conducted by the University of Utah, University of Alabama at Birmingham, and Columbia University. If found that 16.8 million Americans could potentially benefit from lowering their systolic blood pressure – the top number – to 120, much lower than current guidelines of 140 or 150.

The scientists reached their conclusions based on results from the Systolic Blood Pressure Intervention Trial (SPRINT). Their initial analysis, reported back in September, showed that using medications to reach a lower target of 120 mmHg could greatly reduce risk for heart failure, heart attack, and death, compared to a target of 140 mmHg.

Broad implications

“SPRINT could have broad implications,” said lead author Adam Bress, of the University of Utah College of Pharmacy. “Millions of Americans whose blood pressure is under control according to current guidelines may be considered uncontrolled if new guidelines adopt the intensive target of less than 120 mmHg studied in SPRINT.”

The research carries two implications that health care providers must weigh. It suggests 16.8 million Americans could be at risk. It also suggests that same number almost certainly would need to be on prescription medication to reach the lower blood pressure goal.

In other words, it's not only a matter of life and death – billions of dollars are at stake.

“Physicians are going to need to decide how far outside the SPRINT inclusion criteria to go,” said co-author Rachel Hess, a professor of internal medicine and population health sciences at the University of Utah School of Medicine. “It’s going to be a tough decision.”

What to do

If you are concerned about your blood pressure levels, have a frank discussion with your healthcare provider. Make sure he or she is aware of the current debate over safe blood pressure levels and discuss where your levels should be.

Lifestyle factors can also have a large influence on blood pressure. Eating a nutritious, balanced diet low in sodium, getting plenty of exercise, maintaining a normal weight, and avoiding tobacco and excessive alcohol have all been shown to help promote healthy blood pressure.

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