Hypertension Guidelines

Millions of people whose blood pressure was considered borderline high or even normal will now learn they fall into the “prehypertension” range, based on new, more aggressive high blood pressure guidelines from the National Institutes of Health.

Because the risk of heart disease and stroke begins to increase at a blood pressure of 115/75 millimeters of mercury (mmHg), health experts lowered the normally acceptable range to urge more aggressive and earlier treatment of high blood pressure.

The guidelines are included in the Seventh Report of the Joint National Committee (JNC7) on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure.1

Previous classification (1997)

High – 140/90 or above

Borderline – 130-139/85-89

Normal – 129/84 or below

Optimal 120/80 or below

New classification (2003)

High – 140/90 or above

Prehypertension – 120-130/80-89

Normal – 119/79 or below

Key points from the guidelines:

If you have a blood pressure of 120 to 139 systolic (the upper number in a blood pressure measurement) over 80 to 89 diastolic (lower number), you are considered prehypertensive. You need to begin lifestyle modifications to prevent stroke and heart disease. Lifestyle modifications include losing excess weight, exercising, limiting alcohol, following a heart-healthy diet, cutting back on salt, and quitting smoking.

The increase in stroke and heart disease risk begins at blood pressures as low as 115/75 mmHg and doubles with each increase of 20 mmHg systolic blood pressure and ten mmHg diastolic. For example, if your blood pressure were to increase from 115/75 mmHg to 135/85 mmHg, your risk of stroke and heart attack would double.

The lifetime risk for high blood pressure is much greater than previously thought. Ninety percent of those who, at age 55, do not have hypertension will eventually develop it.

If you are older than 50, a systolic blood pressure over 140 mmHg is a more important risk factor for stroke and heart disease than your diastolic blood pressure.

Most people who need medication to control their high blood pressure should take a thiazide-type diuretic either alone or with another hypertension medication. You may need initial treatment with other classes of medications angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), beta-blockers, or calcium channel blockers if you have other conditions, such as diabetes, heart failure, or chronic kidney
Most people with high blood pressure will need two or more medications, including a thiazide-type diuretic, to lower their blood pressure to below 140/90 mmHg, the goal for people with uncomplicated hypertension. If you have other conditions, such as diabetes, heart failure, or chronic kidney disease, your goal blood pressure is lower: 130/80 mmHg.

1 Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (2003). The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. NIH Publication No. 03–5233. Bethesda, MD: U.S. Department of Health and Human Services.

Author: Ellie Rodgers
Primary Medical Reviewer: Steven L. Schneider, M.D., Family Practice

Specialist Medical Reviewer: Robert A. Kloner, M.D., Ph.D., Cardiology


Additional options are always being approved. RESReTATE is a key example of how the treatment of High Blood pressure is chnageing.

Copyright Shera Raisen, M.D. 2011-2021

Disclaimer: This information is not intended to replace the diagnosis,
treatment and services of a physician.
Any recommendations and indications are at the user’s discretion.
For severe or life-threatening conditions, always seek immediate medical attention.

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Be Aware: Public Health Advisory

Los Angeles officials have issued a public health advisory after two dead birds found in Santa Monica tested positive for West Nile Virus. The advisory has been issued to all residents of the city, including residents who live in NMS-owned properties such as LuXe@1539, Olympic Studios, LuXe@Broadway and elsewhere.

WNV is transmitted through the bite of an infected mosquito, according to the advisory. Mosquitos become infected when they feed on birds that have the disease and sometimes subsequently bite humans or animals.

The advisory lists a series of precautions that residents can take to protect themselves from WNV:

– Use insect repellant to keep off mosquitos, especially in the early morning and evening, when mosquitos carrying WNV are most apt to bite.
– Make sure the doors and windows in your apartment have tight-fitting screens, to prevent mosquitos from entering your home.
– Get rid of any sources of standing water, in which mosquitos can lay eggs.

WNV symptoms include headaches, high fever, tiredness, body aches, skin rash and swollen lymph glands.

For more information about the WNV advisory issued in Santa Monica, go here.



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Brentwood Concierge Medicine
11704 Wilshire Boulevard , Suite 200

Los Angeles, CA 90025
Phone: 310-458-9200
Fax: 310-579-2223
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Shera Raisen, MD
11704 Wilshire Boulevard
Suite 200
Los Angeles, CA 90025