KUCHING: Many doctors are following the American Heart Association, American College of Cardiology and nine other groups in redefining high blood pressure (BP) reading as 130/80 (previously 140/90).
Malaysian Diabetes Association (Sarawak Chapter) chairman Dr William Voon said many physicians are now scratching their heads over the American article on the matter as the cutoff point for high blood pressure had long been 140/90.
“Some of us including me have been using 135/85 as the cutoff point in accordance with our Ministry of Health (MoH) guidelines. For us who deal with diabetics, we consider 130/80 the cutoff point for diabetics due to the greater danger they face. The new guideline puts everybody on the same level as diabetics.
“At the cutoff point of 135/85, more than half of people we meet are already hypertensive. I’m afraid that at the new cutoff point, the majority of our population may have to take blood pressure medication,” he said.
The figure for hypertension in Malaysia officially stands at 30 per cent.”
Medical practitioner Dr Aaron Linang meanwhile said Malaysia still follows the clinical practice guidelines (CPG) set by the MoH.
“If there are changes we will follow. I do agree on it (the new high of 130/80) but we have to see based on research or study done in Malaysia.”
Dr Aaron said Malaysia would not adopt the new high for BP that soon because the MoH need to do research on the Malaysian population first.
He said hypertension could not be diagnosed just based on BP because a lot of other factors can affect BP such as pain, temperature, disease or even stress.
The Washington Post in its Nov 13, 2017 edition reported the new high in an article ‘Blood pressure of 130 is the new high’, according to first update of guidelines in 14 years.
It reported the leading heart health experts tightened the guidelines for high BP on Monday, a change that will sharply increase the number of US adults considered hypertensive in the hope that they and their doctors will address the deadly condition sooner.
The change, the first in 14 years, means that 46 per cent of US adults, many of them under 45, are now considered hypertensive. Under the previous guideline, 32 per cent of US adults had high BP, The Washington Post reported.
But the report’s authors predicted relatively few of those who fall into the new hypertensive category will need medication. Rather, they hope that many found with the early stages of the condition will be able to address it through lifestyle changes such as losing weight, improving their diet, getting more exercise, consuming less alcohol and sodium and lowering stress.
The guidelines should be influential in clinical practice, with most health care providers expected to follow the recommendations. In addition to tightening the definition of high BP, the new report does away with the old category of ‘pre-hypertension’, which was defined as a top (systolic) reading of 120 to 139 or a bottom (diastolic) number of 80 to 89.
The guidelines suggest that doctors recommend lifestyle changes for people found to have elevated BP.
Those with Stage 1 hypertension should be assessed for their 10-year risk of heart disease or stroke under the parameters of a widely used matrix for cardiovascular health. Those with more than a 10 per cent chance or other complicating factors should try medication.
The authors of the report expect that many adults younger than 45 will find themselves included under the new threshold. The lower score is expected to triple the number of younger men considered hypertensive and double the number of younger women with high BP.
High BP is the leading cause of death worldwide and the second-leading cause of preventable death in the United States, after cigarette smoking.
Hypertension leads to cardiovascular disease, strokes, severe kidney disease and other maladies that kill millions every year.
BP is affected by a wide variety of factors including genetics, age, diet, exercise, stress and other diseases such as diabetes. Men are more likely to have high BP than women and blacks are more likely than whites. Many people are unaware that they have the condition because there are no symptoms.