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With that surprising exception, the basic health issues associated with hypertension have not changed. What's new is how deep the pool of at-risk people has become and how serious the danger for them is. The National Heart, Lung and Blood Institute (NHLBI) estimates that of 65 million hypertensive Americans, nearly 20 million are not aware they have the condition. Worse, the 65 million figure is just an estimate of the vulnerable population, and that population is a constantly moving target. Every time the nation's obesity needle ticks upward, the number of hypertensive Americans does...
What's more, the closer experts look at how doctors actually diagnose high blood pressure, the more they think they've been grading on a too generous curve. Traditionally, readings between 120/80 and 140/90 have been labeled borderline, less likely to require drugs or other intervention. Now the NHLBI believes that patients may begin approaching danger when their systolic reading--the first number--is as low as 115. Although pressure varies from moment to moment and day to day, a reading that hits the danger zone on two separate visits to the doctor may signal trouble...
...make this point as emphatically as possible, the NHLBI labels the borderline pressure range "prehypertension," a mildly alarming term that was chosen for precisely that reason. "We convened focus groups; presented them terms such as high normal, borderline and abnormal vascular response; and asked them which would get across the idea that they had to take action," says Bakris. "Ninety-eight percent said prehypertension would...
...preteen, to say nothing of a baby. A 2-year-old girl in the 50th percentile for height may have an average blood pressure of just 88/45. That same girl at age 10 should be up to 102/60, still far below the traditional adult benchmark of 120/80. The NHLBI now recommends making blood-pressure readings a part of all visits to the pediatrician. Any child who repeatedly scores in the 95th percentile or above for height, age and sex should be considered in danger...
What experts take from this is not that Lipitor is superior but that the official LDL targets may not be low enough. "LDL lowering is the name of the game," says Dr. James Cleeman, coordinator of the National Cholesterol Education Program at the NHLBI. "I don't think you can conclude that one brand is better than the other." Cleeman's group, which sets U.S. guidelines, is preparing a scientific paper to explain how doctors can best use the latest results in their practice...