New Year is coming soon, and the outpatient department is busier than usual. A 40-year-old man named Mr. Wu recently discovered that his blood pressure was 145/95 and deliberately came to see if there was any issue and if he needed to take medication.
At 40 years old, is 145/95 considered high blood pressure?
The latest standard for high blood pressure:
Greater than 140/90 is diagnosed as high blood pressure;
120-139/80-89 falls under normal high blood pressure;
140-159/90-99 is categorized as stage 1 hypertension;
160-179/100-109 is categorized as stage 2 hypertension;
Greater than 180/110 is categorized as stage 3 hypertension.
Therefore, 145/95 is indeed high blood pressure, specifically stage 1 hypertension.
Mr. Wu often looks up health-related knowledge online and is particularly aware of the dangers of high blood pressure. That’s why he promptly sought medical attention upon noticing elevated blood pressure.
Doctor Wang suggests that since it’s a recent discovery, Mr. Wu should not rush to take medication and should observe for a while.
Mr. Wu: Can I not take medication? Shouldn’t high blood pressure be actively controlled?
Mr. Wu is correct; high blood pressure must be actively managed, but observation can be initiated first.
On one hand, observation entails frequent blood pressure measurements to understand the typical blood pressure levels. On the other hand, newly discovered hypertension doesn’t necessarily require blood pressure-lowering medication.
For blood pressure of 145/95, whether medication is required depends on:
First, in the scenario of not taking medication:
Newly discovered uncomplicated stage 1 hypertension without symptoms
Four conditions: new discovery, only high blood pressure, absence of discomfort due to high blood pressure, blood pressure below 160/100.
If these four conditions are met, medication may not be necessary. However, not taking medication does not imply lack of control; blood pressure management includes non-pharmacological methods.
It is possible to manage without medication by adopting a healthy lifestyle such as quitting smoking and drinking, regular aerobic exercise, low-salt, low-fat, low-sugar diet, weight control, and maintaining a regular sleep schedule.
Give yourself three months. If your blood pressure returns to below 140/90, or even lower, to below 130/80, then medication is definitely unnecessary. If after three months of a healthy lifestyle, your blood pressure remains above 140/90, a bit of blood pressure medication will be needed.
High blood pressure that meets these four conditions can be managed without medication.
Second, in special circumstances:
If high blood pressure is accompanied by insufficient cerebral blood supply or old age.
Generally, it’s rare for elderly individuals to have a blood pressure of 145/95 because as age increases, diastolic pressure typically decreases significantly, making it challenging to maintain at 95.
However, for elderly individuals or those with cerebral blood supply issues, the need for blood pressure medication depends on the individual’s tolerance. Individuals aged 65-79 with a blood pressure ≥150/90 should start taking medication, aiming to reduce it to below 140/90 if tolerated;
For individuals above 80 years old, a blood pressure of ≥160 should prompt medication, aiming at lowering it to below 150/90 if tolerated.
Third, if newly discovered hypertension is combined with diabetes or cardiovascular diseases:
Even though it’s newly diagnosed stage 1 hypertension, when combined with diseases, especially cardiovascular ones or diabetes, immediate medication is necessary to prevent the dual damage of blood pressure and blood sugar.
For instance, diabetes, stroke, coronary heart disease, angina, heart failure, etc., require blood pressure to be swiftly reduced to below 130/80.
Fourth, for blood pressure above 160/100:
For stage 2 or higher hypertension with blood pressure exceeding 160/100, immediate initiation of blood pressure-lowering medication is necessary to prevent severe consequences. Individuals below 65 years old should aim for a target of 140/90 as the primary goal; the secondary goal is below 130/80.
In conclusion, whether newly discovered hypertension necessitates medication requires a specific analysis. However, one sure point is that our goal is to maintain normal blood pressure and, above all, adopt a healthy lifestyle!
(Cardiovascular Doctor Wang officially authorizes this original content. Legal action will be taken against any plagiarism.)
