If you are over 16 years old and your blood pressure is under  130/85 mmHg, you have normal blood pressure according to the European Society for Hypertension (ESH) following its revised version of the 2018 Guidelines for Hypertension.

If the numbers fall just under 140/90 mmHg, you have high-normal condition in European standard contrast to guidelines the American Heart Association(AHA) that revised diagnostic criteria for hypertension above130 / 80mmHg.  The European Society of Hypertension has decided to maintain the standard of diagnosis of hypertension above 140 / 90mmHg through ‘2018 Guideline for Hypertension Treatment’.

In European’s view, the SPRINT(Systolic Blood Pressure Intervention Trial) study, which was the basis of the revised guideline by American Heart Association, narrowly focused for high-risk patients with cardiovascular disease who were older than 60 years of age rather than general population regardless of age.

It is a remarkable change that AHA guidelines in 2017 just as the SPRINT study suggested a target systolic blood pressure of less than 120 mm Hg for elderly hypertensive patients, considering that the guidelines in 2013  recommended target of less than 140 mmHg for patients aged 65 years and older.  In this AHA revision, a category of prehypertension which used to refer to people with a systolic pressure of 120-139, changed to either  ‘elevated blood pressure’ referring to stage between 120-129 (and less than 80) or Stage I hypertension at 130-139(or 80-89). The category doesn’t exist anymore.

While EU and other countries like Japan still hold old guidelines, the implication of the revised guideline in this country still remains to be seen. People with Stage I hypertension became the candidate for hypertension medication under AHA guideline.  The guideline can be a lifesaver for older adults with Diabetes and CAD.  Potentially, more patients are exposed to the increased risk for medication side effects,too. 

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