Thursday, August 14, the American Heart Association and the American College of Cardiology published new recommendations to combat hypertension. The latter dated 2017. And these promise to be more “severe”, for the good of the Americans. Indeed, in the United States, almost half of adults have blood pressure higher than normal.
Early treatment and banned alcohol: new flagship recommendations
Cardiovascular diseases have long been the leading cause of mortality worldwide. And blood pressure is one of the risk factors to be modified to avoid such death. It is still necessary to monitor it and take the right measures … because without treatment, high blood pressure will damage the arteries, thus increasing the risk of heart attack or stroke. This is why, now, faced with high blood pressure, the recommendations are evolving.
Treatment faster installed
The new recommendations concerning blood pressure indicate that if your systolic blood pressure is between 130 and 139 (against 140 before), your doctor must first encourage you to adopt a healthy lifestyle. After 3 to 6 months, if these changes are not enough to reduce your blood pressure to the target value, drug treatment will now be directly recommended. “We now know that the drop in blood pressure also helps reduce the risk of dementia. This is therefore excellent news for these recommendations”, Dr. Daniel Jones, president of the American Heart Association, said Dr. Daniel Jones.
Give up alcohol
Lifestyle changes, according to new guidelines, always understand the maintenance or damage of healthy weight, a healthy diet for the heart, reducing the amount of salt in what you eat and drink, stress management, at least 150 minutes of moderate physical activity per week and resistance exercises such as bodybuilding. But the novelty concerns alcohol consumption. Indeed, the recommendations once stipulated that if you chose to drink, it was necessary to have a drink or less per day for women, and two glasses or less for men. Dr. Jones said that there is now too many evidence of the negative impact of alcohol on blood pressure. The slightest glass is therefore simply not recommended!
Stricter recommendations in general
According to Dr. Gérald Kierzek, medical director of True Medical, it is all monitoring of hypertension that seems to have been redesigned in the United States, and above all reinforced through these new recommendations.
- Total alcohol stop recommended. The new guidelines therefore suggest abstinence rather than moderation, marking a radical change compared to previous recommendations. This novelty is based on the accumulation of evidence showing that no alcohol level is completely “safe” for blood pressure. “”So we finish with the French Paradox and the small glass of daily red wine so-called cardiovascular protector. Today, we know that it is false, it does not protect the arteries! “;
- Reinforced monitoring of women : Guidelines emphasize a narrower monitoring of pregnant women or of childbearing age, recognizing hormonal specificities and particular risks linked to pre-eclampsia;
- Early treatment: The approach becomes more aggressive with an earlier start of treatment, aimed at preventing cardiovascular complications before they settled;
- Sedic restrictions and reinforced weight loss. The loss of at least 5% of body weight is now explicitly recommended to lower or prevent hypertension;
- Strengthening hygieno-dietetic measures : a capital turning point in prevention and even in therapy!
“”In France, it is urgent to leave the compromise“”
These new recommendations are based on the latest studies. But in France, are we going to know the same evolution?
“In France, we will have to face a clinical realism” Assures Dr Gérald Kierzek. “These recommendations may seem drastic because they are part of a public health approach favoring maximum prevention rather than compromise (as with us)”. However, the good health of the French depends on it.
“In France, 20% of known hypertensive patients would not be treated, and the level of understanding of their disease by patients remains low, slowing down observance.”
The new American recommendations reflect an evolution towards aggressive preventive medicine. According to our expert, France would gain from:
- Improve early detection and management of untreated patients;
- Strengthen therapeutic education to improve compliance;
- Consider lower thresholds for patients at high cardiovascular risk;
- Adopt a firmer approach to changes in lifestyle, including alcohol.
“The question is no longer whether these measures are justified, but how fast the other countries will adopt this reinforced preventive strategy” concludes Dr. Kierzek.