In 2017 the American College of Cardiology added a new category to its guidelines for high blood pressure: “Stage 1 Hypertension.” Under the new standards, doctors are advised to place patients in this category (130-139 mmHg / 80-89 mmHg) on treatment. For the European Society of Cardiology, that range is defined as “high normal” blood pressure, with no specific action recommended.
“The idea behind the US guidelines is to lower blood pressure as early as possible and, by presenting patients with a diagnosis, to encourage them to adopt a healthier lifestyle,” explains Prof. Karl-Heinz Ladwig, a researcher at the Clinic for Psychosomatic Medicine and Psychotherapy at the TUM University Clinic rechts der Isar at the Helmholtz Zentrum München.
Motivation factor questionable
Using data from approximately 12,000 patients, Ladwig and his team assessed the situation in Germany. “We studied the 10-year risk of mortality from cardio-vascular disease (CVD) among people in the various hypertension categories in the context of the other risk factors affecting them,” says Seryan Atasoy, the first author of the study, who is working as an epidemiologist at Helmholtz Zentrum München and Ludwig-Maximilians-Universität München.
In the newly created category “Stage 1 Hypertension,” the CVD mortality risk was not significantly higher than among patients with normal blood pressure. “The motivation effect is questionable, too,” says Karl-Heinz Ladwig. Patients in the high-risk category “Stage 2 Hypertension,” where medication is recommended under both the US and the European guidelines, have a much greater risk of dying of heart disease, he explains. “At the same time, risk factors such as smoking and a lack of exercise are far more frequent in that group. That shows that many people do not change their lifestyles despite the diagnosis.”
Read more at Technical University of Munich