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New Blood Pressure Guidelines - Old Dominion Home Care


Have you been to your doctor’s recently and been surprised when the doctor announced that you had high blood pressure?  Not to worry, you have not changed, just the guidelines for the definition of high blood pressure.  So, if you are not aware of the changes recently approved by the American College of Cardiology and the American Heart Association, take a moment to read the new guidelines below.

High blood pressure is when the force of blood flowing through your blood vessels is consistently too high.  High blood pressure is called the “silent killer” because most people don’t know they have it.  Most of the time there are no obvious symptoms.  If left untreated, high blood pressure damages the blood vessels of the circulatory system which can lead to heart attack, stroke or kidney failure.  This is why it is important to be aware of the new guidelines for high blood pressure.

Blood pressure guidelines are not updated regularly.  However, when there is sufficient evidence that a change in the guidelines would prevent the complications of high BP, then it is important that the new guidelines are made public.

The new guidelines are the result of a 3-year study of 9,000 adults 50 and older who had a systolic BP reading of greater than 130 and at least one risk factor for cardiovascular disease (Harvard Health Publishing, Health Topics; April, 2018).  Remember, the systolic number is the top number of a BP reading—example 130/90.  The study, called the SPRINT study, aimed to find out whether treating blood pressure to lower the systolic number to less than 120mm Hg was more effective at reducing the risk of a heart attack or stroke.  This was the first study that included adults under the age of 65.  The results showed that treating blood pressure to reach a goal of 120 or less reduced the risk of a cardiovascular event.

The previous guidelines from 2003, set the threshold at 140/90 and higher for people 65 years of age and under and 150/80 for those older than 65.  Now, with the new definition of high BP set at 130/80 for all adults, this means that “70-79% of men ages age 55 or older are now classified as having high BP (Harvard Health Publishing, Health Topics, April 2018).

Dr. Paul Whelton, lead author of the guidelines says “you’ve already doubled your risk of cardiovascular complications compared to those with a normal level of blood pressure.  We want to be straight with people—you already have a doubling of risk, you need to know about it.  It doesn’t mean you need medication but it’s a yellow light that you need to be lowering your blood pressure, mainly with non-drug approaches.” (

The new blood pressure guidelines are below:

  • Normal: Less than 120/80
  • Elevated: 120-129/80
  • Stage I Hypertension: 130-139/80-89
  • Stage II Hypertension: 140/90 and greater
  • Hypertensive Crisis: 180/120 and up—requires immediate attention

Other Recommendations:

  • Home BP monitoring several times in a week before going to the doctors
  • Best BP monitors are the electronic ones that go around the upper arm. Avoid the finer and wrist monitors which are not accurate.
  • Best Practice for an accurate BP reading:
    • Avoid caffeine, alcohol and cigarettes 30 minutes prior to taking your BP 
    • Sit quietly for 5 minutes with legs uncrossed
    • Support your arm so the elbow is near heart level.
    • Wrap the cuff over the bare skin, not over clothing.
    • Repeat the reading after one minute by leaving the deflated cuff in place. The readings should be close.  If not, repeat 3 times and average the readings.
    • Keep a record including the time of the day.
  • Life-Style Changes that Help Lower your BP
    • Increase the amount of exercise you get weekly—even walking
    • Reduce your sodium (salt) intake to 1,500 mg/day
    • Eat a heart healthy diet—either the DASH or Mediterranean Diet (Source: Paul Conlin—Endocrinologist with VA Boston Healthcare System).



About the author

Judy Grumbly, Principal of AGE, LLC is an experienced certified aging life care manager, an adult nurse practitioner and a licensed registered nurse. Her career path in home care has taken her from the city of Boston, to the mountains of Colorado, to the suburbs of Northern Virginia. In each setting, the mission was to help aging adults maintain their independence in the home setting through education, support with appropriate community resources and coordination of care. Judy is currently the President of the Mid-Atlantic Chapter of Aging Life Care Association (ALCA) and on the Board of the Arlington Neighborhood Village.