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Bar raised to beat high blood pressure

Top News | Reuters and Riley Chan Nov 15, 2017
Up to 90,000 Hongkongers who were previously in a blood pressure comfort zone may soon be in a high-pressure category following a change in guidelines.

The American Heart Association and the American College of Cardiology say people with blood pressure of 130/80 or higher should be treated. The previous trigger was 140/90.

The new bottom line means more than 103 million American adults are now considered to have high blood pressure. It was 72 million before - a figure based on guidelines in place since 2003.

But the revision does not change the definition of normal blood pressure being 120/80 or lower.

Hong Kong took the United States' 2003 high-pressure line into account in 2007, though it follows the World Health Organization's definition.

That states an adult with blood pressure of 140/90 or higher is considered to have hypertension while 120/80 is considered normal.

A blood pressure in between is considered pre-hypertension and should be of concern, according to the Centre for Health Protection.

Surveys conducted by the Census and Statistics Department show that the proportion of people with known hypertension increased from 9.3 percent in 2008 to 12.6 percent in 2014. In 2015, 860,000 people were diagnosed with the condition.

Lau Yuk-kong, president of the Hong Kong College of Cardiology, estimated there would be increase of at least 10 percent in the number of local adults suffering from hypertension if the new American guideline is applied in the SAR, which he expected to happen "very soon."

"The ACC is one of the most authoritative associations in the field, and its guideline should serve as reference," he added.

But Chui Tak-yi, undersecretary for food and health, said Hong Kong is not in pressing need of an adjustment, though experts would be reviewing the new US guideline.

Lau also said the new bar could encourage a healthier lifestyle and make Hongkongers face the problem before it is too late.

"It doesn't mean you have to panic once your blood pressure reaches 130/80 or above, but it is an alarm," he said. "Exercising and reducing your salt intake could help lower the level back to normal."

A Department of Health official said the latest scientific evidence and developments would be monitored closely and follow-up action would be taken as required.

Potentially deadly high blood pressure can be brought under control with a wide array of medications.

But all these drugs have side effects, so the new US guidelines emphasize lifestyle changes, including losing weight, diet and exercise, as the first tool for combating hypertension.

The revision should encourage patients to adhere to recommendations and also spur clinicians "to be more vigorous in their attempts to prescribe lifestyle changes," said Pamela Morris, chair of the American College of Cardiology's Committee on Prevention of Cardiovascular Disease.

The new guidelines also emphasize the importance of accurate blood- pressure measurements, using an average of readings at different times.

Adults with blood pressure of 130/80 "already have double the risk of heart attack compared to someone in the normal range," said Paul Whelton, the lead author of the new guidelines. He is a professor at Tulane University's School of Public Health and Tropical Medicine and the School of Medicine in New Orleans.

He added: "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."



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