This month Americans will be bombarded with heart health messages, and with good cause. Heart disease remains the leading cause of death among the U.S. adult population. As a nation we must do more to fight heart disease, but that starts by adopting a healthier diet and lifestyle, not by over-medicating the population.
On Nov. 14, 2017, half of American adults woke up having been diagnosed with high blood pressure, and they did not even know it. At least that’s what most medical experts pronounced, following the joint publication by the American Heart Association (AHA) and the American College of Cardiology (ACC) of the latest guidelines to diagnose and treat high blood pressure.
The key message of the 2017 guidelines is the new threshold for which we can document a diagnosis of hypertension, to anyone with repeated readings at or greater than 130/80 mmHg.
Based on these new numbers, here is a sample on the impact:
Prevalence of hypertension rises to 46 percent of the U.S. population
The number of males and females under age 45, diagnosed with high blood pressure will now triple and double respectively.
An additional 4.2 million individuals will require medication
The committee’s intention in lowering the threshold was to bring about more awareness in addressing and tackling this critical risk factor, with the purpose of lowering the rate of cardiovascular disease related events. I am in agreement with the target goals and I have always strived for those numbers on my patient population. Where I disagree is the new number for the designation for hypertension.
The effect on how much this will add to an already high cost of health care is not known yet; however we can assume that this will rise significantly based on the same effect after the diabetes guidelines were changed. Aside from the cost of medications, the additional number of individuals now diagnosed with high blood pressure will likely see premium rates increasing for health, life and disability policies in all likelihood.
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It is possible, that with greater emphasis on lifestyle and nutrition promoted in the new guidelines, the net cost may go down; this assumes that a great percentage of the population will apply these recommendations on a consistent and effective manner. The Dietary Approaches to Stop Hypertension (DASH) eating plan is part of the guidelines. It has been around for over 20 years, and recently was named the No. 1 Best Diet by the U.S. News and World Report yet it is underutilized, despite being available for free.
My concern with the new guidelines is not the target goal for blood pressure control on an individual, but rather the label of having high blood pressure. The threshold for doing this should always be higher, lest we risk the potential impact on cost and overtreatment.
Dr. Alan Ackermann, DO, FACC, is a TopLine MD Cardiologist, board certified in internal medicine and cardiovascular diseases. Ackermann is the medical director and founder of the South Florida Institute for Wellness and Health. TopLine is a network representing the highest quality physicians, health care professionals and medical centers across Central and South Florida.
