Overnight, half of American adults were reclassified as hypertensive

Last month, in a move that caught many doctors and patients by surprise, the American Heart Association and the American College of Cardiology moved the goalposts on high blood pressure, lowering the cutoff for normal blood pressure from 140/90 to 120/80.

Previously, blood pressure 120-139/80-89 had been designated “pre-hypertension.”

The changed threshold means that, whereas only 31.9% of Americans were previously said to have elevated blood pressure, now 45.6% are in that category. That’s an additional 31 million people!

The switch is controversial because it flies in the face of several recent studies that have suggested that tighter control of blood pressure in healthy older adults may produce more harm than good, resulting in events such as too-low blood pressure or fainting. This can contribute to falls which cause head injuries and hip fractures.

In fact, just a few months ago, two of the nation’s major primary care organizations, the American College of Physicians, and the American College of Family Physicians, issued recommendations diametrically opposed to the those from the AHA and ACA: Their guidelines state that blood pressure goals should be relaxed—to 150 systolic for older adults!

Advocates of lower blood pressure goals cite the results of the recent SPRINT study which showed that blood pressure lowering to 120/80, even in patients with borderline blood pressure, helped to reduce heart problems and overall risk of dying.

But what gets missed in the discussion is that the SPRINT study participants weren’t just average folks with high blood pressure—they were deemed at high risk of heart problems, with an estimated 10-year risk of cardiovascular disease of 15% or more.

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