"Nine out of every 10 times you see high blood pressure, it's because the diet or the nutrition isn't as good as it could be, it's because we're not as physically active as we could be and should be, and perhaps it's because we're consuming too much alcohol", lead guidelines author Paul K. Whelton, MB, MD, MSc, said in a video released by the American Heart Association (AHA).
Those with Stage 2 high blood pressure are being advised under the guidelines to start medication-likely two medications-while making healthy lifestyle changes.
The updated guidelines were presented at the AHA's Scientific Sessions in Anaheim, California, on November 13 and published by the AHA and the American College of Cardiology.
By lowering the number that is considered too high, doctors are expanding the characterization so now almost half of US adults have hypertension.
Systolic pressure - or the force on arteries during a heartbeat - should not exceed 120.
The guidelines "have the potential of improving the health of millions", and are supported by solid science, said David Goff, director of cardiovascular sciences at the National Heart, Lung, and Blood Institute. High blood pressure used to be defined as 140/90.
According to a release from the AHA, patients with a blood pressure reading of 130/80 should now be considered to have hypertension, or abnormally high blood pressure.
"We want to be straight with people - if you already have a doubling of risk, you need to know about it", Whelton said. "Or do you need, in addition to that, a drug that will lower your blood pressure?" he said.
Previous guidelines classified 140/90 mm Hg as Stage 1 hypertension. He is chair of the 2017 Hypertension Practice Guidelines and a professor of Global Public Health at Tulane University School of Public Health and Tropical Medicine in New Orleans.
Ferdinand said he hopes the new guidelines will push clinicians to treat patients earlier on, which could reduce the number of cardiac-related deaths, specifically heart attack and stokes. The prevalence of high blood pressure is expected to triple among men under age 45, and double among women under 45 according to the report.
But Carey, professor of medicine and dean emeritus at the University of Virginia School of Medicine, said several intensive studies since 2015 show treating older adults to a lower blood pressure goal is beneficial. "Risk is already going up as you get into your 40s".
The new guidelines also stress the importance of using proper technique to measure blood pressure, with a person's level based on an average of two to three readings on at least two different occasions. Home readings can also identify "masked hypertension", when pressure is normal in a medical setting but elevated at home, thus necessitating treatment with lifestyle and possibly medications.
For the past 14 years, high blood pressure has been defined as 140/90, and approximately one in every three people in the US are now diagnosed under this measurement.
The normal limit for blood pressure is considered 120/80.
The update by the American College of Cardiology and the American Heart Association is based on a three-year review of nearly 1,000 studies. They were written by a panel of 21 scientists and health experts who reviewed more than 900 published studies.