The JNC-7 report notes that the risk of cardio vascular disease, beginning at with a blood pressure of 115/75, doubles with each increment of 20/10. Individuals who are normotensive at 55 years of age have a 90 percent lifetime risk for developing hypertension.

"We don't want to frighten the public, we want to get action. Even small changes in blood pressure are important," said Dr. Aram Chobanian, dean of the Boston University school of medicine and chairman of the JNC-7 report committee.

The National Heart, Lung and Blood Institute released these new guidelines for defining high blood pressure and its treatment, which are published in the 14 May 2003 edition of the Journal of the American Medical Association. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC-7) establishes blood pressure measures below 120/80 to be optimal. Values from 120/80 to 130/85 are considered pre-hypertensive. Blood pressure at or above 140/90 is still considered to be high. The significance of these new standards is far reaching.

"We hope it's going to catch people's attention," said Dr Daniel W. Jones, a co-author of the guidelines, addressing the new prehypertension category. "This is not to alarm people but simply deliver the message that ... they are at higher risk for going on to develop hypertension and they need to take action."

An estimated 50 million Americans have high blood pressure. High blood pressure is known as the silent killer because it may not cause symptoms until damage to the body has occured. It raises the risk of heart attacks, strokes, heart failure, kidney damage, blindness and dementia. Another 45 million Americans have what is now considered pre-hypertensive 120/80 blood pressure.

Blood pressure is measured with two numbers. The first number represents systolic pressure when the heart contracts or beats. The second number represents diastolic pressure when the heart relaxes. The guidelines note that with people over 50 years old, systolic blood pressure over 140 is a much more important cardiovascular disease risk factor than diastolic BP.

The new guidelines urge doctors to treat pre-hypertension agressively using standard drugs and lifestyle adjustments - including diet and exercise. Significaltly, the patient's role is recognized as the guidelines note that the patient must be motivated in order for any course of treatment to be effective. The doctor and the patient must agree on goals. The doctor must have empathy for the patient which in turn will build the doctor - patient trust so essential for success of any course of treatment.

source - Journal of the American Medical Association 14 May 2003 early release article. The National Heart, Lung and Blood Institute website.