The American Heart Association Redefines High Blood Pressure

The popular press (an NBC News report is an example) was full of the news yesterday that the American Heart Association (AHA) has come out with new recommendations for the treatment of high blood pressure (hypertension). According to the AHA, hypertension should now be defined as blood pressure above 130/80 mmHg. I'm sure the AHA has its reasons, but I'd be more comfortable with their recommendation if it wasn't the AHA's members (heart doctors) who stand to gain the most from the recommendations. The new recommendations summarily define nearly half the adult population as potential patients!

The new AHA recommendations are different from the recommendations of the Eighth Joint National Committee (JNC 8), an independent, unbiased group chosen from over 400 experts to examine the evidence and provide guidance to clinicians concerning the treatment of hypertension. The JNC 8 recommendations came only after an exhaustive review of the literature and were submitted to peer review by additional experts not on the panel before they were published.  JNC 8 recommends treatment of hypertension to the goal of lowering pressure to below 140/90, not 130/80.

The AHA argues that blood pressure above 130/80 doubles your relative risk of heart disease, compared to pressures below that level. That may be so, but there's a big difference between relative risk and absolute risk. A doubling of relative risk can be as little as an increase in absolute risk from one in a million to two in a million. Think about that before you commit yourself to a lifetime of antihypertensive medication.