The definition of hypertension can be arbitrary


June 08, 1993|By Dr. Simeon Margolis | Dr. Simeon Margolis,Contributing Writer

Q: I am 42 years old, and over the years my blood preassure has remained about 135/85 during my annual physical exams. My doctor had always told me that these were normal values and not to worry about them. After his retirement this spring, I went to another doctor who measured my blood pressure on several occasions and told me that something needed to be done about my readings, which were very similar to those in the past. Which doctor is right?

A: The definition of hypertension is an arbitrary one since the risk of blood pressure-related complications begins to rise when the systolic pressure exceeds 110 mm Hg (millimeters of mercury) and the diastolic pressure is greater than 70 mm Hg. Because of this, some experts believe that blood pressures should be considered normal only when they are less than 110/70. A new classification of high blood pressure was recommended this year by the Joint National Committee on Detection, Evaluation and Treatment of High Blood Pressure. Although the committee kept the long-standing mark of 140/90 or greater as hypertension or high blood pressure, they defined "normal blood pressure" as less than 130 systolic and 85 diastolic. They also added a new category of "high normal blood pressure" (systolic 130-139 and diastolic 85-89). Because your blood pressures have consistently been in the range of high normal, you would be well advised to follow the advice of your new doctor.

Dr. Margolis is professor of medicine and biological chemistry at the Johns Hopkins School of Medicine.

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