New Nutrition, Physical Activity, and Obesity Info-graphic

Where We’ve Been and Where We’re Going

In 2008, Federal Physical Activity Guidelines for Americans was released, and the Healthy People 2020 physical activity objectives developed in 2010 reflected these guidelines. From 2008 to 2016, the rate for adults aged 18 years and over who met the guidelines for aerobic physical activity and muscle-strengthening activity increased by 23.6%, from 18.2% to 22.5% (age adjusted), exceeding the Healthy People 2020 target of 20.1%.

In contrast, between 2005–2008 and 2013–2016, the obesity rate among adults aged 20 years and over increased by 13.9%, from 33.9% to 38.6% (age adjusted), while the change in the rate was not statistically significant among youth aged 2–19 years (16.1% in 2005–2008 and 17.8% in 2013–2016).

Between 2005–2008 and 2011–2014, there was no change in the mean daily vegetable intake of persons aged 2 years and over (0.76 cup equivalents of total vegetables per 1,000 calories, age adjusted, in both 2005–2008 and 2011–2014). The Healthy People 2020 target is 1.16 cup equivalents per 1,000 calories.

Physical Activity (PA-2.4)

  • Healthy People 2020 objective PA-2.4 tracks the proportion of adults who report meeting current federal physical activity guidelines for aerobic physical activity and for muscle-strengthening activity: at least 150 minutes of light/moderate or 75 minutes of vigorous physical activity per week or an equivalent combination of moderate- and vigorous-intensity activity and physical activities specifically designed to strengthen muscles at least twice per week.
    • HP2020 Baseline: In 2008, 18.2% of persons aged 18 years and over met the current federal physical activity guidelines (age adjusted).
    • HP2020 Target: 20.1%, a 10% improvement over the baseline.
    • Most Recent: In 2016, 22.5% of persons aged 18 years and over met the current federal physical activity guidelines (age adjusted).
  • In 2016, adults who identified with 2 or more races had the highest rate among racial and ethnic groups, with 25.2% of adults aged 18 years and over (age adjusted) who met current federal physical activity guidelines for aerobic physical activity and for muscle-strengthening activity. Age-adjusted rates for other racial/ethnic groups were:
    • 14.7% among the American Indian or Alaska Native population; the best group rate was 71.1% higher
    • 16.6% among the Hispanic population; the best group rate was 51.7% higher
    • 17.0% among the Asian population; the best group rate was 48.0% higher
    • 20.8% among the black non-Hispanic population; the best group rate was 21.0% higher
    • 24.3% among the Native Hawaiian or other Pacific Islander population; not significantly different than the best group rate
    • 25.0% among the white non-Hispanic population; not significantly different than the best group rate
  • Males aged 18 years and over had a 39.9% higher rate of meeting the current federal physical activity guidelines than females (26.3% versus 18.8%, age adjusted) in 2016.
  • Among education groups for adults aged 25 years and over, those with advanced degrees had the highest rate of meeting the current federal physical activity guidelines (32.8%, age adjusted) in 2016. Rates (age adjusted) for individuals in other education groups were:
    • 8.9% among those with less than a high school education; the best group rate was more than 3.5 times as high
    • 13.2% among high school graduates; the best group rate was 2.5 times as high
    • 19.5% among those with some college education; the best group rate was 68.3% higher
    • 23.4% among those with an associate’s degree; the best group rate was 40.3% higher
    • 29.9% among those with a 4-year college degree; the best group rate was 9.8% higher

Physical Activity by Education: Adults Aged 25 Years and Over, 2016

Physical Activity by Education: Adults Aged 25 Years and Over, 2016

Data Source: National Health Interview Survey (NHIS), CDC/NCHS.

  • In 2016, adults aged 18–24 years had the highest rate of meeting the physical activity guidelines, 30.7%, among age groups. Rates for other age groups were:
    • 27.0% among those aged 25–44 years; the best group rate was 13.9% higher
    • 20.8% among those aged 45–54 years; the best group rate was 47.8% higher
    • 17.1% among those aged 55–64 years; the best group rate was 79.3% higher
    • 15.7% among those aged 65–74 years; the best group rate was twice as high
    • 10.1% among those aged 75–84 years; the best group rate was 3 times as high
    • 3.9% among those aged 85 years and over; the best group rate was 8 times as high
  • Adults aged 18–64 years with private health insurance had the highest rate of meeting the physical activity guidelines (28.9%, age adjusted) among insurance groups in 2016. Those with public insurance and the uninsured had rates of 14.0% and 15.9% (age adjusted), respectively. The rate for adults with private insurance was more than twice the rate for those with public insurance and 81.4% higher than the rate for the uninsured.
  • In 2016, adults aged 18 years and over in families with incomes 600% or more of the poverty threshold had the highest rate of physical activity, 34.3% (age adjusted). Rates (age adjusted) for individuals in other income groups were:
    • 11.8% for those with incomes under the poverty threshold; the best group rate was more than 2.5 times as high
    • 14.5% for those with incomes 100% to 199% of the poverty threshold; the best group rate was more than 2 times as high
    • 20.0% for those with incomes 200% to 399% of the poverty threshold; the best group rate was 71.8% higher
    • 26.6% for those with incomes 400% to 599% of the poverty threshold; the best group rate was 28.9% higher
  • In 2016, adults aged 18 years and over living in metropolitan areas had a 55.6% higher rate of meeting the physical activity guidelines than those living in non-metropolitan areas (23.8% versus 15.3%, age adjusted).
  • Adults aged 18 years and over born in the U.S. had a 38.5% higher rate of meeting the physical activity guidelines than adults born outside the U.S. (23.9% versus 17.2%, age adjusted) in 2016.
  • Among adults aged 18 years and over, married persons had the highest rate of meeting the physical activity guidelines (22.2%, age adjusted) among groups by marital status in 2016. Rates for widowed, never married, cohabitating, and divorced persons were 7.5%, 21.0%, 21.4%, and 21.4% (age adjusted), respectively. The rate for married adults was more than 2.5 times that for widowed persons. The rates for cohabitating partners and never married and divorced persons were not significantly different than the best group rate.

Endnotes:

  • Unrounded values with additional decimal places beyond what are shown here are used in calculating health disparities, including identifying the best group and calculating the differences between groups. Rounded values displayed here are used in calculating changes over time and percent change needed to meet the target.
  • Unless otherwise stated, all disparities described are statistically significant at the 0.05 level of significance.
  • Data (except those by educational attainment, health insurance status, and age group) are age adjusted to the 2000 standard population using the age groups 18–24, 25–34, 35–44, 45–64, and 65 years and over. Data by educational attainment are adjusted using the age groups 25–34, 35–44, 45–64, and 65 years and over. Data by health insurance status are adjusted using the age groups 18–44, 45–54, and 55–64. Data by age group are not age adjusted. Age-adjusted rates are weighted sums of age-specific rates.
  • Data for this measure are available annually and come from the National Health Interview Survey, CDC/NCHS.

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Obesity in Adults (NWS-9)

  • Healthy People 2020 objective NWS-9 tracks the proportion of adults with obesity (BMI ? 30).
    • HP2020 Baseline: In 2005–2008, the rate of obesity was 33.9% among adults aged 20 years and over (age adjusted).
    • HP2020 Target: 30.5%, a 10% improvement over the baseline.
    • Most Recent: In 2013–2016, the rate of obesity was 38.6% among adults aged 20 years and over (age adjusted).
  • Males aged 20 years and over had a lower rate of obesity than females (36.5% versus 40.5%, age adjusted) in 2013–2016. The rate for females was 11.0% higher than that for males.
  • Among racial and ethnic groups, the Asian non-Hispanic population had the lowest (best) rate of obesity, 12.5% of adults aged 20 years and over (age adjusted) in 2013–2016. Rates (age adjusted) for other racial and ethnic groups were:
    • 48.0% among the black non-Hispanic population; more than 3.5 times the best group rate
    • 44.9% among the Hispanic population; more than 3.5 times the best group rate
    • 37.1% among the white non-Hispanic population; 3 times the best group rate

Adult Obesity by Race/Ethnicity, 2013–2016

Adult Obesity by Race/Ethnicity, 2013–2016

Data Source: National Health and Nutrition Examination Survey (NHANES), CDC/NCHS.

  • Adults aged 20 years and over without activity limitations had a lower rate of obesity than adults with activity limitations (36.6% versus 45.0%, age adjusted) in 2013–2016. The rate for adults with activity limitations was 23.1% higher than the rate for persons without activity limitations.
  • Among educational attainment groups for adults aged 25 years and over, college graduates or above had the lowest (best) rate of obesity, 29.7% (age adjusted) in 2013–2016. Rates (age adjusted) for other educational attainment groups were:
    • 41.1% among adults with less than a high school education; 38.4% higher than the best group rate
    • 44.2% among adults with a high school education; 48.7% higher than the best group rate
    • 46.8% among adults with some college or an AA degree; 57.7% higher than the best group rate
  • Adults aged 20 years and over living in families with incomes 500% or more of the poverty threshold had the lowest rate of obesity among family income groups, 31.2% (age adjusted) in 2013–2016. Rates (age adjusted) for individuals in other family income groups were:
    • 42.1% for those with incomes under the poverty threshold; 34.6% higher than the best group rate
    • 42.9% for those with incomes 100% to 199% of the poverty threshold; 37.2% higher than the best group rate
    • 41.5% for those with incomes 200% to 399% of the poverty threshold; 32.7% higher than the best group rate
    • 39.2% for those with incomes 400% to 499% of the poverty threshold; 25.5% higher than the best group rate
  • Adults aged 20 years and over born outside the U.S. had a lower rate of obesity than adults born in the U.S. (29.9% versus 40.6%, age adjusted) in 2013–2016. The rate for adults born in the U.S. was 36.0% higher than the rate for adults born outside the U.S.
  • Among groups by health insurance status for adults aged 20–64 years, those with private health insurance had the lowest rate of obesity, 37.1% (age adjusted) in 2013–2016, whereas adults with public insurance had a rate of 45.8% (age adjusted) and those without insurance had a rate of 39.2% (age adjusted). Compared to the rate for those with private insurance, the rate for those with public health insurance was 23.4% higher and the rate for those without health insurance was not significantly different.
  • Among broad age groups, adults aged 20–44 years had the lowest rate of obesity, 36.8% in 2013–2016. Rates for other age groups were:
    • 42.1% among adults aged 45–64 years; 14.3% higher than the best group rate
    • 37.6% among adults aged 65 years and over; not significantly different than the best group rate
  • When further refining the age groups, adults aged 80 years and over had the lowest rate of obesity, 26.7% in 2013–2016. Rates for the other age groups were:
    • 27.2% among adults aged 20–24 years; not significantly different than the best group rate
    • 39.2% among adults aged 25–44 years; 46.7% higher than the best group rate
    • 40.5% among adults aged 45–54 years; 51.5% higher than the best group rate
    • 43.8% among adults aged 55–64 years (highest rate); 63.9% higher than the best group rate
    • 42.0% among adults aged 65–74 years; 57.2% higher than the best group rate
    • 36.4% among adults aged 75–79 years; 36.1% higher than the best group rate

Endnotes:

  • Unrounded values with additional decimal places beyond what are shown here are used in calculating health disparities, including identifying the best group and calculating the differences between groups. Rounded values displayed here are used in calculating changes over time and percent change needed to meet the target.
  • Unless otherwise stated, all comparisons described are statistically significant at the 0.05 level of significance.
  • Data for this measure are available biennially and come from the National Health and Nutrition Examination Survey (NHANES), CDC/NCHS. Preferably 4 years of data are pooled for analysis when available.
  • The terms “Hispanic or Latino” and “Hispanic” are used interchangeably in this report.
  • Data (except those by education status, health insurance coverage, and age group) are age adjusted to the 2000 standard population using the age groups 20–29, 30–39, 40–49, 50–59, 60–69, 70–79, and 80 years and over. Data by education status are adjusted using the age groups 25–29, 30–39, 40–49, 50–59, 60–69, 70–79, and 80 years and over. Data by health insurance coverage are adjusted using the age groups 20–29, 30–39, 40–49, 50–59, and 60–64 years. Data by age group are not age adjusted. Age-adjusted rates are weighted sums of age-specific rates.

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Obesity in Children and Adolescents (NWS-10.4)

  • Healthy People 2020 objective NWS-10.4 tracks the proportion of children and adolescents with obesity (BMI at or above the gender- and age-specific 95th percentile from the CDC Growth Charts).
    • HP2020 Baseline: In 2005–2008, the rate of obesity was 16.1% among children and adolescents aged 2–19 years.
    • HP2020 Target: 14.5%, a 10% improvement over the baseline.
    • Most Recent: In 2013–2016, the rate of obesity was 17.8% among children and adolescents aged 2–19 years.
  • Among racial and ethnic groups, the Asian non-Hispanic population had the lowest (best) rate of obesity, 9.8% of youth aged 2–19 years in 2013–2016. Rates for other racial and ethnic groups were:
    • 23.6% among the Hispanic population; more than twice the best group rate
    • 20.4% among the black non-Hispanic population; more than twice the best group rate
    • 14.7% among the white non-Hispanic population; 50.2% higher than the best group rate
  • Youth aged 2–19 years with private health insurance had the lowest rate of obesity, 14.8% in 2013–2016. Those with public insurance and the uninsured both had rates of 20.9%. The rate for youth without health insurance was 41.3% higher than the best group rate; the rate for youth with public insurance was 41.2% higher than the best group rate.i
  • Youth aged 2–19 years living in families with incomes 400% to 499% of the poverty threshold had the lowest rate of obesity among family income groups, 11.9% in 2013–2016. Rates for youth in other family income groups were:
    • 21.0% for those with incomes under the poverty threshold; 75.8% higher than the best group rate
    • 20.7% for those with incomes 100% to 199% of the poverty threshold; 73.3% higher than the best group rate
    • 16.9% for those with incomes 200% to 399% of the poverty threshold; not significantly different than the best group rate
    • 12.3% for those with incomes 500% or more of the poverty threshold; not significantly different than the best group rate

Child and Adolescent Obesity by Family Income, 2013–2016

Child and Adolescent Obesity by Family Income, 2013–2016

Data Source: National Health and Nutrition Examination Survey (NHANES), CDC/NCHS.

Endnotes:

  • iUnrounded values with additional decimal places beyond what are shown here are used in calculating health disparities, including identifying the best group and calculating the differences between groups. Rounded values displayed here are used in calculating changes over time and percent change needed to meet the target.
  • Unless otherwise stated, all comparisons described are statistically significant at the 0.05 level of significance.
  • Data for this measure are available biennially and come from the National Health and Nutrition Examination Survey (NHANES), CDC/NCHS. Preferably 4 years of data are pooled for analysis when available.
  • The terms “Hispanic or Latino” and “Hispanic” are used interchangeably in this report.

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Total Vegetable Intake (NWS-15.1)

  • Healthy People 2020 objective NWS-15.1 tracks the contribution of total vegetables to the diets of the population aged 2 years and over.
    • HP2020 Baseline: In 2005–2008, 0.76 cup equivalents of total vegetables per 1,000 calories was the mean daily intake of persons aged 2 years and over (age adjusted).
    • HP2020 Target: 1.16 cup equivalents per 1,000 calories (age adjusted), 90th percentile of usual vegetable intake at baseline.
    • Most Recent: In 2011–2014, 0.76 cup equivalents of total vegetables per 1,000 calories was the mean daily intake of persons aged 2 years and over (age adjusted).
  • Among racial and ethnic groups, the Asian non-Hispanic population aged 2 years and over had the highest mean daily vegetable intake, 0.95 cup eq. per 1,000 kcal (age adjusted) in 2011–2014. Intakes (age adjusted) for other racial and ethnic groups were:
    • 0.66 cup eq. per 1,000 kcal among the black non-Hispanic population; the best group rate was 44.0% higher
    • 0.75 cup eq. per 1,000 kcal among the white non-Hispanic population; the best group rate was 25.4% higher
    • 0.81 cup eq. per 1,000 kcal among the Hispanic population; the best group rate was 17.0% higher
  • Females aged 2 years and over had a 16.4% higher mean daily vegetable intake than males (0.82 versus 0.70 cup eq. per 1,000 kcal, age adjusted) in 2011–2014.
  • Adults aged 20 years and over without activity limitations had a 22.4% higher mean daily vegetable intake than adults with activity limitations (0.87 versus 0.71 cup eq. per 1,000 kcal, age adjusted) in 2011–2014.
  • Persons aged 51 years and over had the highest mean daily vegetable intake, 0.94 cup eq. per 1,000 kcal (not age adjusted) in 2011–2014, among broad age groups. Intakes for other age groups were:
    • 0.52 cup eq. per 1,000 kcal among persons aged 2–18 years; the best group rate was 78.8% higher
    • 0.78 cup eq. per 1,000 kcal among persons aged 19–50 years; the best group rate was 20.7% higher

Mean Daily Intake of Total Vegetables by Age, 2011–2014

Mean Daily Intake of Total Vegetables by Age, 2011–2014

Data Source: National Health and Nutrition Examination Survey (NHANES), CDC/NCHS.

  • Among educational attainment groups for adults aged 25 years and over, college graduates or above had the highest mean daily vegetable intake, 0.96 cup eq. per 1,000 kcal (age adjusted) in 2011–2014. Intakes (age adjusted) for other educational attainment groups were:
    • 0.77 cup eq. per 1,000 kcal among adults with less than a high school education; the best group rate was 24.9% higher
    • 0.80 cup eq. per 1,000 kcal among adults with a high school education; the best group rate was 19.5% higher
    • 0.84 cup eq. per 1,000 kcal among adults with some college education or an AA degree; the best group rate was 14.4% higher
  • Persons aged 2 years and over living in families with incomes 400–499% of the poverty threshold had the highest mean daily vegetable intake, 0.80 cup eq. per 1,000 kcal (age adjusted) in 2011–2014. Intakes (age adjusted) for other income groups were:ii
    • 0.71 cup eq. per 1,000 kcal among persons from families with incomes under the poverty threshold; the best group rate was 13.1% higher
    • 0.71 cup eq. per 1,000 kcal among persons from families with incomes 100–199% of the poverty threshold; the best group rate was 14.0% higher
    • 0.77 cup eq. per 1,000 kcal among persons from families with incomes 200–399% of the poverty threshold; not significantly different than the best group rate
    • 0.80 cup eq. per 1,000 kcal among persons from families with incomes 500% or more of the poverty threshold; not significantly different than the best group rate
  • Persons aged 2 years and over born outside the U.S. had an 18.8% higher mean daily vegetable intake than persons born in the U.S. (0.88 versus 0.74 cup eq. per 1,000 kcal, age adjusted) in 2011–2014.

Endnotes:

  • iiUnrounded values with additional decimal places beyond what are shown here are used in calculating health disparities, including identifying the best group and calculating the differences between groups. Rounded values displayed here are used in calculating changes over time and percent change needed to meet the target.
  • Unless otherwise stated, all comparisons described are statistically significant at the 0.05 level of significance.
  • Data for this measure are available biennially and come from the National Health and Nutrition Examination Survey (NHANES), CDC/NCHS. Preferably 4 years of data are pooled for analysis when available. Cup equivalents were calculated using the USDA Food Patterns Equivalents Database (FPED).
  • The terms “Hispanic or Latino” and “Hispanic” are used interchangeably in this report.
  • Data (except those by educational attainment, disability status, health insurance status, and age group) are age adjusted using the age groups 2–5, 6–11, 12–19, 20–29, 30–39, 40–49, 50–59, 60–69, 70–79, and 80 years and over. Data by educational attainment are adjusted using the age groups 25–29, 30–39, 40–49, 50–59, 60–69, 70–79, and 80 years and over. Data by disability status are adjusted using the age groups 20–29, 30–39, 40–49, 50–59, 60–69, 70–79, and 80 years and over. Data by health insurance status are adjusted using the age groups 2–3, 4–8, 9–13, 14–18, 19–30, 31–50, and 51–64. Data by age group are not age adjusted. Age-adjusted rates are weighted sums of age-specific rates.
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Quit Smoking With Yoga

Quitting Smoking

Almost 70 percent of adult smokers want to quit smoking, according to a U.S. national survey. Conventional quit-smoking treatments, including counseling and medication, can double or triple the chances that a smoker will quit successfully. Some people also try complementary health approaches to help them kick the smoking habit. In one survey of people who visited a tobacco cessation clinic, two-thirds said that they were interested in trying complementary approaches.

Bottom Line

  • Current evidence suggests that some mind and body practices—such as mindfulness meditation-based therapies, yoga, and relaxation techniques (guided imagery or progressive muscle relaxation)—may help people quit smoking.
  • Although it’s possible that acupuncture might help people stop smoking for short periods of time, there’s no consistent evidence that it helps people quit permanently.
  • Studies of hypnosis as an aid to quitting smoking have had conflicting results.
  • There is no current evidence that the dietary supplements S-adenosyl-L-methionine (SAMe), lobeline (from the herb Lobelia inflata), or St. John’s wort can help people quit smoking.
  • The natural product cytisine, primarily used in Central and Eastern European countries for smoking cessation, is not currently approved by the U.S. Food and Drug Administration (FDA) but has been shown to be effective in helping smokers quit. NCCIH is part of a strategic collaboration with Achieve Life Science, Inc. and OncoGenex Pharmaceuticals, Inc. and is supporting a series of non-clinical studies on cytisine as part of the overall development of a smoking cessation treatment. These non-clinical studies are required by the FDA to support the submission of an Investigational New Drug application.

Safety

  • The mind and body practices discussed above are generally considered safe for healthy people when they’re performed appropriately. If you have any health problems, talk with both your health care provider and the complementary health practitioner/instructor before starting to use a mind and body practice.
  • If you’re considering a dietary supplement, remember that “natural” does not necessarily mean “safe.” Some supplements may have side effects, and some may interact with drugs or other supplements. In particular, St. John’s wort has been shown to interact with many medications, and these interactions can have serious consequences.

For more information on quitting smoking, visit smokefree.gov, the National Cancer Institute’s quit-smoking resource.

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High blood pressure redefined

High blood pressure redefined for first time in 14 years: 130 is the new high

American Heart Association/American College of Cardiology Guidelines

November 13, 2017 Categories: Scientific Statements/Guidelines

Highlights

  • High blood pressure is now defined as readings of 130 mm Hg and higher for the systolic blood pressure measurement, or readings of 80 and higher for the diastolic measurement. That is a change from the old definition of 140/90 and higher, reflecting complications that can occur at those lower numbers.
  • In the first update to comprehensive U.S. guidelines on blood pressure detection and treatment since 2003, the category of prehypertension is eliminated.
  • While about 14 percent more people will be diagnosed with high blood pressure and counseled about lifestyle changes, there will only be a small increase in those who will be prescribed medication.
  • By lowering the definition of high blood pressure, the guidelines recommend earlier intervention to prevent further increases in blood pressure and the complications of hypertension.

Embargoed until 12:30 p.m. PT / 3:30 p.m. ET Monday, Nov. 13, 2017

ANAHEIM, California, Nov. 13, 2017 — High blood pressure should be treated earlier with lifestyle changes and in some patients with medication – at 130/80 mm Hg rather than 140/90 – according to the first comprehensive new high blood pressure guidelines in more than a decade. The guidelines are being published by the American Heart Association (AHA) and the American College of Cardiology (ACC) for detection, prevention, management and treatment of high blood pressure.

The guidelines were presented today at the Association’s 2017 Scientific Sessions conference in Anaheim, the premier global cardiovascular science meeting for the exchange of the latest advances in cardiovascular science for researchers and clinicians.

Rather than 1 in 3 U.S. adults having high blood pressure (32 percent) with the previous definition, the new guidelines will result in nearly half of the U.S. adult population (46 percent) having high blood pressure, or hypertension. However, there will only be a small increase in the number of U.S. adults who will require antihypertensive medication, authors said. These guidelines, the first update to offer comprehensive guidance to doctors on managing adults with high blood pressure since 2003, are designed to help people address the potentially deadly condition much earlier.

The new guidelines stress the importance of using proper technique to measure blood pressure. Blood pressure levels should be based on an average of two to three readings on at least two different occasions, the authors said.

High blood pressure accounts for the second largest number of preventable heart disease and stroke deaths, second only to smoking. It’s known as the “silent killer” because often there are no symptoms, despite its role in significantly increasing the risk for heart disease and stroke.

Paul K. Whelton, M.B., M.D., M.Sc., lead author of the guidelines published in the American Heart Association journal, Hypertension and the Journal of the American College of Cardiology, noted the dangers of blood pressure levels between 130-139/80-89 mm Hg.

“You’ve already doubled your risk of cardiovascular complications compared to those with a normal level of blood pressure,” he said. “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.”

Blood pressure categories in the new guideline are:

  • Normal: Less than 120/80 mm Hg;
  • Elevated: Top number (systolic) between 120-129 and bottom number (diastolic) less than 80;
  • Stage 1: Systolic between 130-139 or diastolic between 80-89;
  • Stage 2: Systolic at least 140 or diastolic at least 90 mm Hg;
  • Hypertensive crisis: Top number over 180 and/or bottom number over 120, with patients needing prompt changes in medication if there are no other indications of problems, or immediate hospitalization if there are signs of organ damage.

The new guidelines eliminate the category of prehypertension, which was used for blood pressures with a top number (systolic) between 120-139 mm Hg or a bottom number (diastolic) between 80-89 mm Hg. People with those readings now will be categorized as having either Elevated (120-129 and less than 80) or Stage I hypertension (130-139 or 80-89).

Previous guidelines classified 140/90 mm Hg as Stage 1 hypertension. This level is classified as Stage 2 hypertension under the new guidelines.

The impact of the new guidelines is expected to be greatest among younger people. The prevalence of high blood pressure is expected to triple among men under age 45, and double among women under 45 according to the report.

Damage to blood vessels begins soon after blood pressure is elevated, said Whelton, who is the Show Chwan professor of global public health at Tulane University School of Public Health and Tropical Medicine and School of Medicine in New Orleans. “If you’re only going to focus on events, that ignores the process when it’s beginning. Risk is already going up as you get into your 40s.”

The guidelines stress the importance of home blood pressure monitoring using validated devices and appropriate training of healthcare providers to reveal “white-coat hypertension,” which occurs when pressure is elevated in a medical setting but not in everyday life. Home readings can also identify “masked hypertension,” when pressure is normal in a medical setting but elevated at home, thus necessitating treatment with lifestyle and possibly medications.

“People with white-coat hypertension do not seem to have the same elevation in risk as someone with true sustained high blood pressure,” Whelton said. “Masked hypertension is more sinister and very important to recognize because these people seem to have a similar risk as those with sustained high blood pressure.”

Other changes in the new guideline include:

  • Only prescribing medication for Stage I hypertension if a patient has already had a cardiovascular event such as a heart attack or stroke, or is at high risk of heart attack or stroke based on age, the presence of diabetes mellitus, chronic kidney disease or calculation of atherosclerotic risk (using the same risk calculator used in evaluating high cholesterol).
  • Recognizing that many people will need two or more types of medications to control their blood pressure, and that people may take their pills more consistently if multiple medications are combined into a single pill.
  • Identifying socioeconomic status and psychosocial stress as risk factors for high blood pressure that should be considered in a patient’s plan of care.

The new guidelines were developed by the American Heart Association, American College of Cardiology and nine other health professional organizations. They were written by a panel of 21 scientists and health experts who reviewed more than 900 published studies. The guidelines underwent a careful systematic review and approval process. Each recommendation is classified by the strength (class) of the recommendation followed by the level of evidence supporting the recommendation. Recommendations are classified I or II, with class III indicating no benefit or harm. The level of evidence signifies the quality of evidence. Levels A, B, and C-LD denote evidence gathered from scientific studies, while level C-EO contains evidence from expert opinion.

The new guidelines are the successor to the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC7), issued in 2003 and overseen by the National Heart, Lung, and Blood Institute (NHLBI). In 2013, the NHLBI asked the AHA and ACC to continue the management of guideline preparation for hypertension and other cardiovascular risk factors.

Co-authors are Robert M. Carey, M.D., vice chair of the writing committee; Wilbert S. Aranow, M.D.; Donald E. Casey, Jr., M.D., M.P.H., M.B.A.; Karen J. Collins, M.B.A.; Cheryl Dennison Himmelfarb, R.N., A.N.P., Ph.D.; Sondra M. DePalma, M.H.S., P.A.-C, C.L.S.; Samuel Gidding, M.D.; Kenneth A. Jamerson, M.D.; Daniel W. Jones, M.D.; Eric J. MacLaughlin, Pharm.D.; Paul Muntner, Ph.D.; Bruce Ovbiagele, M.D., M.Sc., M.A.S.; Sidney C. Smith, Jr., M.D.; Crystal C. Spencer, J.D.; Randall S. Stafford, M.D., Ph.D.; Sandra J. Taler, M.D.; Randal J. Thomas, M.D., M.S.; Kim A. Williams, Sr, M.D.; Jeff D Williamson, M.D., M.H.S. and Jackson T. Wright, Jr., M.D., Ph.D., on behalf of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Author disclosures and our collaborating organization partners are listed online and in the appendix to the manuscript.

Additional Resources:

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The American Heart Association/American Stroke Association receives funding mostly from individuals. Foundations and corporations donate as well, and fund specific programs and events. Strict policies are enforced to prevent these relationships from influencing the association’s science content. Financial information for the American Heart Association, including a list of contributions from pharmaceutical and device manufacturers and health insurance providers are available at www.heart.org/corporatefunding.

About the American Heart Association

The American Heart Association, the world’s leading voluntary health organization devoted to fighting cardiovascular disease, is devoted to saving people from heart disease and stroke –  the two leading causes of death in the world. We team with millions of volunteers to fund innovative research, fight for stronger public health policies, and provide lifesaving tools and information to prevent and treat these diseases. The Dallas-based association is the nation’s oldest and largest voluntary organization dedicated to fighting heart disease and stroke. To learn more or to get involved, call 1-800-AHA-USA1, visit heart.org or call any of our offices around the country. Follow us on Facebook and Twitter.

About the American College of Cardiology
The American College of Cardiology is the professional home for the entire cardiovascular care team. The mission of the College and its more than 52,000 members is to transform cardiovascular care and to improve heart health. The ACC leads in the formation of health policy, standards and guidelines. The College operates national registries to measure and improve care, offers cardiovascular accreditation to hospitals and institutions, provides professional medical education, disseminates cardiovascular research and bestows credentials upon cardiovascular specialists who meet stringent qualifications. For more, visit acc.org or follow @ACCinTouch on Twitter and Facebook.

For Media Inquiries: 214-706-1173

AHA – Maggie Francis: 214-706-1382; maggie.francis@heart.org

ACC – Nicole Napoli: 202-669-1465; nnapoli@acc.org

For Public Inquiries: 1-800-AHA-USA1 (242-8721)

heart.org and strokeassociation.org

 

 

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November is National Diabetes Month

November is National Diabetes Month, do any of these symptoms sound familiar to you? If so, give us a call for an appointment! 30.3 million People have diabetes (9.4% of the U.S. population) There are 7.2 million un-diagnosed (23.8% of people with diabetes) in the U.S. Let us help you find your way to better health

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Help us fill our wall with HEARTS! All donations of $2 or more go toward funding our new and improved clinic. Most funding is secured, but community members, donors and foundation support is requested. We so appreciate all who have already contributed to helping Bethel Family Clinic better serve you!

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