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Are you one of the “new” hypertensive people? 30 million Americans are.

By Peter DiMaria

Home Care Enfiled: New Hypertension Guidelines

One day in November 2017, more than 30 million Americans went to sleep with normal blood pressure and woke up hypertensive. No, they did not develop a high blood pressure overnight. What happened was that the American College of Cardiology (ACC) and the American Heart Association (AHA), together with nine other medical and research associations updated the previous guidelines for hypertension, from 2003.

The new guidelines were written by a panel of 21 scientists and health experts who reviewed more than 900 published studies showing that the safe levels of blood pressure are in reality lower than previously prescribed. These studies also point to the fact that people with a systolic blood pressure (the top number) of 130 to 139, or a diastolic blood pressure (the bottom number) of 80 to 89, are already at risk of cardiovascular disease caused by their blood pressure. In other words, they are hypertensive.

The American College of Cardiology (ACC) and the American Heart Association (AHA) have two declared objectives in changing the hypertension guidelines:

  • Incentive people to adopt more healthy lifestyles;
  • Reduce confusion caused by different definitions and terms adopted previously, like “pre-hypertensive”.

"We want to be straight with people – if you already have a doubling of risk, you need to know about it. It doesn't mean you need medication, but it's a yellow light that you need to be lowering your blood pressure, mainly with non-drug approaches.", says Paul K. Whelton, MB, MD, MSc, FACC, lead author of the guidelines, on the ACC website. 

This diagram from the ACC explains the changes:

 Home care guidelines for hypertension

What does that mean for Senior Care - Suffield

The new threshold for normal levels is reduced from 130 to 120 in the high and 90 to 80, in the low. That means that 30 million Americans who were considered to have normal or “pre-hypertensive” levels are now considered hypertensive stage 1. As a consequence, nearly half of Americans have high blood pressure under the new guidelines published in November 2017.

There aren't still statistics broken down to age, according to the new guidelines. But, as hypertension incidence is higher according to age, it is expected that a vast majority of Americans over 50 and 60 years old are now considered hypertensive. The condition affects equally men and women, as they age.

What does that mean to you?

So, if it happened that your blood pressure was normal when you went to bed but became high when you woke up one day in November (only because the guidelines changed), here’s what it means: you need to improve your life habits to get it where it needs to be and the best way to do it is exercising and eating a healthy diet, with low salt, sugar, and trans or saturated fats.

Here are the recommendations of the American Heart Association:


According to the American Heart Association, a healthy lifestyle will include 150 minutes per week of moderate intensity exercise or 75 minutes of vigorous activity-or a combination of both. If you need to lower your blood pressure or cholesterol, the recommendation is 40 minutes of moderate to intense aerobic exercise, three or four times per week.

The DASH diet

The DASH acronym stands for Dietary Approaches to Stop Hypertension. Research studies show that people who adopt this diet are able to lower their blood pressure in under two weeks.

The DASH diet includes variety of nutritious foods from all food groups with a variety of fruits and vegetables, whole grains, low-fat dairy products, skinless poultry and fish, nuts and legumes, and non-tropical vegetable oils.

DASH also means limiting the amount of saturated fats, trans fats, and sodium. To be able to lower your blood pressure, you should have no more than 2,400 mg of sodium (approximately 1 teaspoon of salt) each day. Cutting sodium down to 1,500 mg per day will reduce your blood pressure even more. In any case, a reduced sodium intake by even just 1,000 mg per day can help reduce blood pressure.

It is also important to reduce the intake of alcohol, limiting it to one drink a day for women or two drinks a day for men.

No smoking

Finally, it is recommended to quit smoking (if you do) and avoid secondhand smoking.


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