CDA Essentials 2018 • Volume 5 • Issue 2

21 Issue 2 | 2018 | N ews and E vents  Why did the task force update the guidelines on high blood pressure? A review of the evidence tells us that the risk of four major complications (heart attack, stroke, heart failure, and kidney failure) doubles when one’s blood pressure goes from 120/80 to 130/80. So we created nomenclature that allows patients to be armed with this information and help clinicians understand how they can make a difference to their patients’ well-being.  What’s changed in the new ACC/AHA guidelines? The new definitions are: a blood pressure of less than 120/80 is normal, and between 120–129 /<80 is elevated. Stage 1 hypertension is systolic between 130–139 or diastolic between 80–89, and stage 2 hypertension is systolic at least 140 or diastolic at least 90. It’s a big change!  What does this mean for patients who previously thought they had normal blood pressure, but now find they are diagnosed with hypertension? Patients who were previously not categorized as hypertensive now have HIGH BLOOD PRESSURE A New Definition in the U.S. The AmericanCollege of Cardiology (ACC) and the American Heart Association (AHA) have lowered their definition of high blood pressure, redefining the “new normal” as less than 120/80mmHg in new guidelines, published in Hypertension in November 2017. Dr. Joaquin Cigarroa cigarroa@ohsu.edu Previously, high blood pressure was defined as greater than 140/90. According to Dr. Joaquin Cigarroa, head of the division of cardiovascular medicine at Oregon Health & Science University and a member of the ACC/AHA task force responsible for updating the guidelines, the new definition means that almost 1 in 2 Americans will be diagnosed with hypertension—a 13% increase in the at-risk population compared to estimates based on the older definition. CDA spoke with Dr. Cigarroa to find out what the guideline changes means for dentists and other health care providers. the understanding that they are at an increased risk of the four major complications I mentioned. Empowered with that knowledge, they have the tools to improve their health. Here’s the remarkable thing about these guidelines: they emphasize the critical role of lifestyle interventions: the importance of nutrition in enhancing health and fighting disease, and physical activity. If you combine these two entities (nutrition and exercise) 70% of newly diagnosed hypertensives will have an appropriate and effective treatment plan without medications.  When are medications appropriate? Patients who expect to treat their high blood pressure with medicine alone are missing the point. You need the fundamentals of nutrition and exercise to have the most impact. The other aspect of this is how we monitor blood pressure and understand whether we are effectively treating a patient. The new guidelines point out the critical nature of monitoring one’s blood pressure in the home environment on a consistent basis, and to think about averages. If you think about adjusting medications based on four blood pressure readings a year, that’s crazy! This interviewhasbeencondensedandedited. Theviewsexpressedarethoseoftheauthor anddonotnecessarilyreflecttheopinions orofficialpoliciesoftheCanadianDental Association.