New High Blood Pressure Guidelines
In November of 2017, the American Heart Association and the American College of Cardiology updated their guidelines for the detection, prevention and management of high blood pressure.
The new guidelines replaced the last comprehensive set of protocols from 2003, and lower the criteria or definition of high blood pressure. These new guidelines should allow for earlier intervention and help reduce the complications and problems that result from sustained elevated blood pressure readings.
The new definition of high blood pressure is likely to result in nearly half of the U.S. adult population being diagnosed with high blood pressure. The greatest impact is expected to be among younger people.
However, only a small increase is expected in the number of adults requiring high blood pressure medication, since one of the goals of the new guidelines was to make individuals aware sooner of their heightened risks for complications associated with high blood pressure and for those individuals to hopefully make earlier dietary and lifestyle modifications to help lower their blood pressure.
Previously, individuals with blood pressure above 140/90 were categorized as having High Blood Pressure. The table below from the American Heart Association shows the new Blood Pressure Categories.
BLOOD PRESSURE SYSTOLIC DIASTOLIC
CATEGORY Upper Number Lower Number
NORMAL Less than 120 and Less than 80
ELEVATED 120 – 129 and Less than 80
HIGH BLOOD PRESSURE 130 – 139 or 80 – 89
HIGH BLOOD PRESSURE 140 or Higher or 90 or Higher
HYPERTENSIVE CRISIS Higher than 180 and/or Higher than 120
(Consult your doctor
as soon as possible)
There are also new recommendations for the way health care providers should take blood pressure measurements. The new recommendation is for patients to rest for at least five minutes prior to their blood pressure being taken and then to average at least two readings over two different visits. It’s important to not base the diagnosis on just one single blood pressure measurement, and to monitor your blood pressure regularly.
How Does This Impact my Dental Appointment?
The dentist has an important role in screening undiagnosed and untreated high blood pressure, which will lead to improved monitoring and treatment; and a higher life expectancy for the patient. The screening also provides an opportunity to educate our patients on the relationship between good oral health and overall systemic health.
High blood pressure can and does impact your dental health. Maintaining a healthy blood pressure will help lower your risk for several oral conditions and problems.
For example, patients who are on high blood pressure medicine may have higher incidence of dry mouth, inflammation of the gums, white (lichenoid) lesions of the mouth and some taste alterations. Patients with dry mouth typically experience a higher decay rate with their teeth and inflammation of the gums is a complicating factor in Periodontal Disease.
Certain surgical procedures (extractions, periodontal surgery, implant placement) are also compromised or jeopardized when a patient’s blood pressure is uncontrollably high. There is additional risk for prolonged bleeding during surgical procedures because of the elevated high blood pressure.
Patients with High Blood Pressure also tend to have a higher rate of complications in the dental office, since the stress and anxiety associated with dental treatment often times further elevates their heightened blood pressure; thus potentially creating a Hypertensive Crisis.
Damage to the blood vessels begins soon after blood pressure is elevated. It’s much smarter and better to work on lowering the blood pressure as soon as it is detected to be elevated; instead of waiting until there is a problem (Stroke, Heart Attack, …) before addressing the underlying cause.
Although there is a family history component to High Blood Pressure, there are still risk factors and lifestyle choices which can impact and lower an individual’s risk for future disease. Please monitor your blood pressure regularly and consult with your Physician if your blood pressure is above the normal range.
(Excerpts from the American Heart Association, American College of Cardiology and the American Dental Association Websites)