For decades people with diabetes and others were glad to hear that their blood pressure was normal. Normal meant the systolic pressure was between 120 and 139 mm Hg and the diastolic pressure was between 80 and 89 mm Hg. Well, this past Spring normal was changed. The National Institute of Health (NIH) has changed the health labels linked to blood pressure numbers so what was once normal is  now prehypertension.

Table 1 shows the new blood pressure categories. The important important change in definition is prehypertension. Prehypertension has been squeezed between normal and stage 1 hypertension. So, what used to be normal is now prehypertension at a systolic pressure range between 120-139.

Normal is now less than 120 mm Hg. The reason for that is researchers have found out that your risk for heart and blood vessel issues begin to rise at 115 mm Hg over 75 mm Hg. That’s not all. Your risk for heart disease doubles for every 20 mm Hg of systolic pressure rise and every 10 mm Hg increase in the diastolic pressure.

What Does The New Standards Mean

The new standards mean we will have to raise our sense of urgency around reducing our blood pressure to the new normal. The standards will put even more pressure on people with Type 2 diabetes to:

• Eat less salt
• Increase our physical activity levels
• Eat less food
• Eat more foods that lowers blood pressure, like fruits and veggies
• Lose more body fat
• Work to reduce blood cholesterol
• Try to laugh more to reduce your stress – Hey try some yoga
• We don’t yet need medication – just motivation

We will need to do as much as we can naturally to bring down our blood pressure and delay taking blood pressure medications by trying all of the above suggestions. But, if we can’t, then you have to follow your doctor’s orders.

As the patient, and the captain of your health team ask your doctor
questions, get tips about diet and exercise, and mention any side effects
and other troubles you might be having with your medications.

What category are you in? These are the categories in updated blood pressure guidelines from the National Institutes of Health.
	Systolic (top number)		Diastolic (bottom number)	What you should do
Normal	Less than 120 Used to be <130	and	Less than 80 Used to be <85	Keep up the good work!
Prehypertension Blood pressure in this category used to be considered high-normal.	120-139	or	80-89	Change health habits. If you’re heavy, lose weight. Reduce salt in your diet. Eat more fruits and vegetables and get more exercise. Moderate alcohol consumption might help, too. Medications are not recommended at this stage.
Stage 1 hypertension	140-159	or	90-99	Change health habits and take a blood pressure medication, probably starting with a diuretic. If you have another health problem (diabetes, angina, kidney disease, etc.) then a different drug (beta blocker, ACE inhibitor, etc.) is probably necessary.
Stage 2 hypertension The Stage 3 hypertension category has been eliminated.	160 and higher Used to be 160-179	or	100 and higher Used to be 100-109	Change health habits and take two blood pressure medications, usually a diuretic and something else.
Source: Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure, www.nhlbi.nih.gov/guidelines/hypertension