YouDocs, 1-21-14: New HBP guidelines explained


Q: I'm on high blood pressure meds, and my reading is always around 148/85. Now the news says that if I'm below 150/90 I don't have to worry about it. Can I stop taking my meds? -- Stan G., Austin, Texas

A: Stan, don't stop taking blood pressure medications suddenly -- you could suffer a rebound that knocks you off your feet. Talk to your doctor about any adjustments.

And there have been a lot of reports about new hypertension treatment guidelines. But did you know that those guidelines, published in JAMA, haven't been endorsed by the National Heart, Lung and Blood Institute, which established the review panel that issued them?

The Guidelines:

1. The definition of high blood pressure as 140/90 remains the same. (Our recommendation for most folks under age 60: 115/75; 60 or over can aim for 130/85!)

2. Folks over 60 with HBP should start antihypertensive medications when their systolic (or top) number reaches 150 or higher OR when the diastolic (or bottom) number is 90 or higher. BUT the goal is blood pressure below 140/90.

3. If you've got HBP and are younger than 60 or have kidney disease or diabetes, begin HBP medication at a systolic pressure of 140 or higher and diastolic pressure of 90 or higher. (Substantially lower than 140/90 spares the brain, heart and kidneys.)

4. And finally, everyone should adopt a healthy lifestyle.

Our suggestions for you:

If you're on HBP meds, stay on them. If you need HBP meds, take them. They save lives. (If you object to your meds' side effects, ask your doctor about alternatives; there are around 150 drugs approved to manage BP.)

And whether you are at risk for HBP or have it, aim for 30 minutes of activity daily, heading for 10,000 steps. (If you have severely high BP, kidney disease or diabetes, consult your doc.)

Q: I'm done with holiday partying: hanging with friends, drinking and spending more than I should! I want to get healthy again. What now? -- Willie F., Atlanta

A: Hold on a minute, before you give up too much! Hanging with friends, drinking (in moderation) and being generous are actually good for you! And if you want to get healthy, they're a pretty good place to start.

Seeing friends regularly for a walk around the neighborhood (make a pact to do it three days a week) or enjoying afternoon tea together actually makes you healthier. Feeling connected boosts oxytocin levels, and that builds bonds. Plus, the release of oxytocin is contagious, so you spread the cheer. That reduces your responses to stressful events (such as overeating or drinking too much) and builds a network of support that's key for emotional health.

Having a drink or two most days benefits your cardiovascular system. Men 29-69 who are moderate drinkers (two a day) lower their risk for heart disease by 30 percent -- and women who are moderate drinkers (one a day) also protect their heart and are less likely to be overweight than non-drinking girlfriends. Plus, it boosts immune strength.

And throughout the year, keep your generous impulses going. It doesn't cost anything to help a neighbor or volunteer in a soup kitchen. You'll reduce your stress responses, have a more optimistic outlook (known to boost healthy decision-making) and live better and longer -- what a great gift you get from being generous to others!

(Email your health and wellness questions to Dr. Oz and Dr. Roizen at

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