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Overview
Top Take-Home Messages
1. High blood pressure is the most prevalent and modifiable risk factor
for the development of cardiovascular diseases, including coronary
artery disease, heart failure, atrial fibrillation, stroke, dementia,
chronic kidney disease, and all-cause mortality. The overarching
blood pressure treatment goal is <130/80 mm Hg for all adults, with
additional considerations for those who require institutional care,
have a limited predicted lifespan, or are pregnant.
2. Clinicians should collaborate with community leaders, health
systems, and practices to implement screening of all adults in their
communities and implement guideline-based recommendations
regarding prevention and management of high blood pressure to
improve rates of blood pressure control.
3. Multidisciplinary team-based care is effective in assessing and
addressing patient access to medications and other structural
barriers to support individual patient needs and thereby reduce
barriers to achieving hypertension control. Team members may
include physicians, pharmacists, nurse practitioners, nurses,
physician assistants/associates, dieticians, community health
workers, and other health care professionals.
4. Blood pressure is classified by the following framework: normal
blood pressure is defined as <120 mm Hg systolic and <80 mm Hg
diastolic; elevated blood pressure as 120 to 129 mm Hg systolic and
<80 mm Hg diastolic; stage 1 hypertension as 130 to 139 mm Hg
systolic or 80 to 89 mm Hg diastolic; and stage 2 hypertension as
≥140 mm Hg systolic or ≥90 mm Hg diastolic.
5. For all adults, lifestyle changes, including maintaining or achieving
a healthy weight, following a heart-healthy eating pattern (such as
DASH), reducing sodium intake, increasing dietary potassium intake,
adopting a moderate physical activity program, managing stress, and
reducing or eliminating alcohol intake are strongly recommended to
prevent or treat elevated blood pressure and hypertension.
6. Initiation of medication therapy to lower blood pressure in addition
to lifestyle interventions is recommended for all adults with
average blood pressure ≥140/90 mm Hg and/or for selected adults
with average blood pressure ≥130/80 mm Hg who have clinical
cardiovascular disease, previous stroke, diabetes, chronic kidney
disease, or increased 10-year predicted cardiovascular risk of ≥7.5%
defined by PREVENT™.
