Leslie T. Cooper Jr., the Jacksonville-based chairman of cardiology at Mayo Clinic’s three campuses, has high hopes for the public health impacts of new diagnostic guidelines for blood pressure treatment.
The new guidelines, developed by the American Heart Association, American College of Cardiology and nine other health professional organizations and published Monday, also will likely help increase awareness of heart and stroke risks, he said.
“Lower blood pressure is going to be good for everyone,” he said. “My hope is this will raise community awareness and engage them to get their blood pressure checked. … It’s a good thing for people to be aware of.”
The new guidelines, the first since 2003, were written by a panel of 21 scientists and health experts who reviewed about 900 published studies. That data included growing evidence that the lower your blood pressure, the better your health, they said.
High blood pressure accounts for the second-largest number of preventable heart disease and stroke deaths, second only to smoking.
Under the new definition, about 46 percent of the U.S. adult population has high blood pressure, or hypertension, compared to 32 percent under the previous definition. The impact is expected to be greatest among younger people — the prevalence of high blood pressure is expected to triple among men younger than 45 and double among women younger than 45.
An estimated 59 percent of black men, 56 percent of black women, 47 percent of white men and 41 percent of white women will have high blood pressure, according to the Heart Association.
The intent of the new guidelines is early intervention because damage to blood vessels begins soon after blood pressure is elevated, said lead author Paul K. Whelton.
“If you’re only going to focus on events, that ignores the process when it’s beginning,” he said. “Risk is already going up as you get into your 40s. … It doesn’t mean you need medication, but it’s a yellow light that you need to be lowering your blood pressure.”
John Warner, an intervention cardiologist in Dallas, is president of the Heart Association. Ironically, Warner, who has a family history of heart disease, had a mild heart attack at the association conference where the new guildelines were presented.
“This change reflects the latest research that shows health problems can occur at those lower [measurement] levels,” he said. “We must more aggressively help people lower their blood pressure to healthier levels. Early intervention can help prevent problems, slow damage that has already started and lower the risk for a cardiac event or stroke.
“Maintaining blood pressure within safe targets is not a one-time event. Such control requires close monitoring and regular communication between patients and health care providers.”
One of Mayo’s blood-pressure patients is Jamaal Fudge, 34, who looks to be the epitome of physical health.
The Jacksonville native is a former NFL safety who played for the Jaguars and the Atlanta Falcons. He is now a physical education teacher and retains the taut, muscular build of a pro football player.
But last fall he was diagnosed with high blood pressure, which significantly increases the risk for heart disease and stroke.
“I was surprised,” he said. “I didn’t think it applied to me.”
In fact, he had already been warned. He was told his blood pressure was elevated during a physical when he left the NFL, but he attributed it to the stress of the exam and did not follow up. He only did so at the urging of his wife, Michelle, a medical secretary at Mayo Clinic, after he began having headaches.
“The challenge was getting him to … have a sense of urgency,” she said.
Fudge was prescribed medication to control the condition, and his blood pressure readings dropped to what was then viewed as a safe level. But under new the guidelines his treatment may need to be re-evaluated.
He said he’s learning about the new guidelines and is spreading the word about them as part of the Heart Association’s informational campaign, as well as through social media and his physical education students.
See also: Photos: New standards in blood pressure classifications
“I am going to try to get them to exercise more and eat right to help prevent this,” Fudge said, adding that he hopes to dissuade them from lifestyles filled with “pizza, chicken nuggets and videogames.”
Mayo’s Cooper said the new guidelines do not necessarily require visiting a doctor or taking expensive tests, at least not immediately. Blood pressure testing machines are available for use at many drug and grocery stores and testing kits can be purchased for home use, he said.
“I have one in my house,” he said.
Some patients are genetically predisposed to high blood pressure — Fudge said both his parents and his brother and sister also have the condition — but there are risk factors that can be controlled, Cooper said. Most newly diagnosed people will be advised to change their diet and exercise levels, but not require immediate medication.
“You don’t necessarily need drugs, but … a healthy lifestyle,” which includes eating healthy, weight maintenance and exercising regularly. “They are in your control.”
Beth Reese Cravey: (904) 359-4109