Changing B/P numbers?

[handyrn]

I work for a company sometimes doing health counselling. One of the things we do is b/p. The information that I am to give them (and the accompanying pamphlet) says that b/p should be LESS THAN 120/80. When I went to nursing school, we were taught that 120/80 is perfect b/p but some people run a little over (or under) that and that it is perfectly normal for them if there b/p is consistently at that rate. (Up to a point.) For example, if Mrs. Jones' b/p runs 132/84 ALL the time, that is normal for her, and thus, ok. What this pamphlet is saying is that 120/80 is pre-hypertensive and that you should strive to get that number lower. Has this changed? Is it normal now to tell people that 120/80 is too high?

[Otessa, BSN, RN]

There are new guidelines regarding this and to be 120/80 or less is preferrable.

[smily nurse, BSN, RN]

American Heart Assoc states 120/70...... like Bp it is variable

[Isitpossible, LPN, LVN]

my school teaches less than 120/80 is preferable...

[Forever Sunshine, ASN, RN]

I would think they are trying to say that 120/80 is pre-hypertensive because they want you to maintain that and not let it get any higher.

Everyones B/P is different though. We have a resident that runs ...at what would be hypertensive.. for a normal person. But that number is normal for her and thats what she lives at. Shes on at least 6 or 7 different blood pressure pills too. We do have a ballpark number of whats high for her and thats when we know to contact the doctor and go from there.

[coast2coast]

I believe you now want either number to be less than 120/80.

From http://hyper.ahajournals.org/cgi/reprint/45/1/142 , these are the HTN stages I was taught:

SBP

SBP 120-139 or DBP 80-89 = Prehypertensive

SBP 140-159 or DBP 90-99 = Stage 1 HTN

SBP >160 or DBP >100 = Stage 2 HTN

So 120/80 is technically "prehypertensive, " as is Mrs Jones at 132/84. Although I would imagine the treatment for those 2 scenarios would be different ...

[anonymurse]

Yeah, it's a matter of fashion. BP isn't that bad. How many times has the advice changed on the earliest age a baby should get solid food?

[aquaphone]

According to the American Heart Association's new guidelines, a BP of 130/83 would be high. So if that woman's systolic usually runs in the 130's, that puts her at risk for stroke, vascular disease, etc.

Check it out:

http://www.americanheart.org/presenter.jhtml?identifier=4623

[allstudentnurses, ASN, RN]

I was taught in school that 110/70 is the ideal bp and has been for a few years now.

[coast2coast]

Forgot to add - I don't think tolerating a personal baseline (such as 132/84) is recommended. That number is now considered to be "at risk" regardless of how many years the pt has lived with it.

However, I'm having trouble finding a source for that so - that is just my intuition on the subject. If anybody knows for sure please share.

[CBsMommy]

OP, yes, 120/80 is now considered prehypertensive per the AHA guidelines and if that is the only thing the patient has wrong with them, we need to work with them on getting their BP below that point.

Coast2Coast - It depends on the patient, which is why we need to tailor to their needs. For instance, if someone has a co-morbidity of hyperthyroidism, we may expect clinically that not only is their BP going to be a little on the high side but their heart rate will be as well. It doesn't necessary mean they have heart disease. The same goes with someone who has had an MI in the past, is on beta-blockers and their BP is now reading 70/50. It doesn't mean they DON'T have heart disease, it means their meds are working.

This is why we look at a patient as a whole and not just one assessment factor.

[Katie5]

I work for a company sometimes doing health counselling. One of the things we do is b/p. The information that I am to give them (and the accompanying pamphlet) says that b/p should be LESS THAN 120/80. When I went to nursing school, we were taught that 120/80 is perfect b/p but some people run a little over (or under) that and that it is perfectly normal for them if there b/p is consistently at that rate. (Up to a point.) For example, if Mrs. Jones' b/p runs 132/84 ALL the time, that is normal for her, and thus, ok. What this pamphlet is saying is that 120/80 is pre-hypertensive and that you should strive to get that number lower. Has this changed? Is it normal now to tell people that 120/80 is too high?

That it is perfectly normal for a person to run a consistent BP, does not make it perfectly normal.

Their "prefectly normal" when used against the universal standard is "imperfectly normal".