New blood pressure guidelines, released by The National Heart, Lung, and Blood Institute (NHLBI), categorize 22% of American adults as either having high blood pressure or facing an increased risk for developing high blood pressure. The new guidelines were developed by a broad coalition of professional and lay organizations and published in the Journal of the American Medical Association.

The National High Blood Pressure Education Program Coordinating Committee searched for and analyzed studies on blood pressure and health from 1997 to April 2003. Based on this newer evidence, the committee replaced the previous 1997 guidelines with new standards for the identification, prevention, and treatment of high blood pressure.

New classification cutoffs

The upper range of what was considered 'normal' in the old guidelines (140/90 mm Hg) now falls into a new category, 'prehypertensive.' Prehypertension is defined as a having a systolic reading (the top number) anywhere between 120 and 139, OR a diastolic (the bottom number) reading of 80-89 mm Hg. Prehypertensive individuals are at an increased risk for progression to hypertension. A reading of less than 120/80 mm Hg is now considered 'normal.'

Attention to health behaviors

Prehypertension does not require medication unless another condition such as diabetes or kidney disease is present. But it does require careful attention to lifestyle behaviors. Even people with normal blood pressure are encouraged to develop and maintain healthful habits to keep it in check.

These include:

• losing excess weight or maintaining a healthful weight
• eating a heart-healthy diet
• being physically active
• limiting alcoholic beverages
• limiting salt and sodium
• avoiding smoking

DASH to healthful eating

In keeping with the 1997 guidelines, the new report suggests that following the DASH diet - an eating plan emphasizing vegetables, fruit, and low-fat dairy products - may help lower blood pressure without medications, by as much as 8 to 14 mm Hg (systolic).

The committee noted that people who are 55 or older - and with normal blood pressure - have a 90% chance of developing high blood pressure at some point down the road. Elevated blood pressure means a greater risk of stroke, kidney disease, and heart failure. Make it a point to ask your health care provider for the results of your blood pressure reading and the facts you need to keep your blood pressure in check.