AMA wants you to remember new numbers for healthy blood pressure _lowres

Advocate staff photo by ANDREA MABRY -- Catherine Lasperches, a family nurse practitioner, checks Chad Brown's blood pressure at the New Orleans Musician's Clinic on Thursday, February 6, 2014. Brown plays the trumpet in the Free Agents Brass Band and has been attending the clinic for about six years.

For decades during every doctor’s visit, Americans hoped they would hear two magic numbers: 120 over 80.

That enviable blood pressure reading is now obsolete.

In December, a report in the Journal of the American Medical Association reset the guidelines for healthy blood pressure to a level below 150 over 90.

“I tell you it is still controversial,” said Dr. Denzil Moraes, a cardiologist at Louisiana Cardiology Associates at Our Lady of the Lake Physician group. “These are new guidelines, and we’re going to have to see what that does to population health.”

The change was made, Moraes said, because doctors did not see a great benefit in treating people with, according to the old standard, slightly high blood pressure.

“And most doctors want their patients (at or below) 140 over 90,” he said. “So 120 over 80 is no longer the case. It’s more like 140 over 80 now.”

But what do these numbers actually mean?

Blood pressure is the force your blood creates when it pushes against the walls of your arteries, the blood vessels going in and out of your heart. Doctors use two numbers to gauge a patient’s blood pressure — the systolic and the diastolic. A blood pressure meter measures the force of the blood and expresses that force in the number of millimeters it raises the mercury in the measuring instrument.

The first number in a reading, called the systolic, measures the pressure in the arteries right after the heart contracts. It should be at 150 or below.

“So it’s going to be the highest point of the heart in the cycle,” Moraes said. “If you can visualize a heart pumping, the peak of that blood flow coming out of the aorta is the systolic blood pressure.”

The second number, called the diastolic, measures the pressure when the heart is not contracting. It should be at 90 or below. More than 76 million American adults have been diagnosed with high blood pressure, according to the American Heart Association.

Hypertension, the medical term for the condition, is often a result of stiffness of the arteries, Moraes said, but other conditions — diabetes, chronic kidney disease and some artery problems — can raise the pressure, too.

High blood pressure can lead to life-threatening medical problems, Moraes said.

“That sets the patient up for complications down the line with stroke, heart disease and kidney disease,” he said.

While a high blood pressure reading may raise your blood pressure even more, doctors will monitor blood pressure over a period of time to ensure a patient’s reading is consistently high.

If it remains high, a doctor will order a patient to lose weight, try a low sodium diet and increase exercise before writing a prescription, Moraes said.

While blood pressure numbers are something every patient should keep in mind, Moraes said, doctors should monitor all aspects of a patient’s well being — not just those they can measure with a number.

“Focusing on a number is a good thing, but we should not focus solely on a number,” Moraes said. “You have to look at the total health of the patient.”