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A Mass General Perspective: New Hypertension Guideline

In This Article

  • The American College of Cardiology (ACC) and the American Heart Association (AHA) released a new guideline on hypertension that defines stage 1 hypertension as 130 to 139 mm Hg systolic or 80 to 89 mm Hg
  • This definition means roughly half of all U.S. citizens have high blood pressure
  • Randy Zusman, MD, director of Mass General’s Division of Hypertension, comments on how this change will impact the way he treats patients

At the 2017 American Heart Association (AHA) Scientific Sessions, the American College of Cardiology (ACC) and the AHA released a new guideline on hypertension.

The Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults now defines stage 1 hypertension as 130 to 139 mm Hg systolic or 80 to 89 mm Hg.

Some determining factors for the change stemmed from the recently completed SPRINT trial, as well as meta-analyses of other clinical trials that “clearly showed lower is better when it comes to blood pressure control,” says Randy Zusman, MD, director of Massachusetts General Hospital’s Division of Hypertension.

This new definition classifies roughly half of all US citizens as having high blood pressure.

“There are now innumerable patients whose blood pressure values are no longer normal, and many others who are now reclassified as being hypertensive,” says Dr. Zusman.  “These patients may need to have additional medications added to their regimens, or be started on medications, respectively, along with a re-emphasis on lifestyle modification.”

How does this new hypertension definition impact the way clinicians treat their patients? According to Dr. Zusman, the treatments will not drastically change.

“For most patients, we have the means to control their blood pressure through lifestyle modification along with drug therapy,” he says.

But in more complex scenarios, a specialized center is warranted. Two scenarios that would warrant referral to a hypertension center are:

  • Failure to respond to a 3-drug regimen that typically treats hypertension
  • Having symptoms consistent with a secondary cause of hypertension

With any new change comes uncertainty, but Dr. Zusman defers to the data. “Apply these new guidelines to your clinical practice,” he recommends. “The 2017 Hypertension Guideline Data Supplements supporting the new recommendations are clear and strong.”

  of Americans are now considered hypertensive after the release of the new hypertension guideline

Learn more about hypertension treatment at Mass General

Refer a patient to the Corrigan Minehan Heart Center


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Health care professionals at this year’s American Heart Association’s Scientific Sessions discussed late-breaking research, innovative treatment approaches and brand new guidelines. The conversations carried over from the podium and conference halls onto Twitter.