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Dr C Venkata S Ram, Australia 05 January 2018

Anyone with BP more than 130/80 mmHg is now considered as having HT.
There is lot of evidence to suggest that any BP higher than 130/80 mmHg can be detrimental to health.
So, the gold standard for HT diagnosis is not 140/90 but 130/80 mmHg. This applies to all age groups and comorbidities.
People with BP more than 130/80 mmHg should be counseled for lifestyle changes and then, drug treatment.
So, the new cut-off between normal and high BP is 130/80 and not 140/90 mmHg.
b blockers are now rated as “secondary” drugs for HT, not primary.
First-line drugs for HT are diuretics, CCBs, ACEIs and ARBs.
Among the diuretics, the preferred choice is chlorthalidone, not HCTZ or indapamide.
The new guidelines will change the way medicine will be practiced from now on. The BP should be 130/80 mmHg or lower (New Recommendation).

5 main points to be emphasized in the new guideline

A strong emphasis on BP measurement.
A new BP classification system.
A new approach to decision making for treatment that incorporates the underlying CV risk.
Lower targets for BP during HT management.
Strategies to improve BP control during treatment with an emphasis on lifestyle approaches.

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