New blood pressure goals
VCU School of Pharmacy faculty, alumni and students have provided the Dr. Rx column for Richmond’s Fifty Plus magazine since December 2009. We now share those columns on the SOP website, as well, for those who might not have seen the most recent issue.
Serving as Dr. Rx for February 2016 was Mimi Baker, a fourth-year Pharm.D. student. Her undergraduate concentrations at VCU were biology and history. Her areas of interest are transitions of care and its sustainability in geriatrics and specialty pharmacy.
Q.: I’m taking all of these pills for my blood pressure and my blood sugar. But I don’t know the numbers that I should be shooting for. What are my goals?
A.: You are not alone with this question! I often see patients who are taking medications but do not know what their goals are. New blood pressure guidelines were released by the Eighth Joint National Committee (JNC8) in 2014, and there is a slight difference in these and the blood pressure goals of a few years ago.
Keep in mind that your goal depends on your age and whether you have diabetes or chronic kidney disease. Here are your blood pressure goals based on the JNC8 2014 Evidence-Based Guidelines for the Management of High Blood Pressure in Adults:
- 18 years or older with no diagnosis of high blood pressure: lower than 120/80
- 18 years or older with diabetes or chronic kidney disease: lower than 140/90
- Younger than 60 with high blood pressure: lower than 140/90
- 60 years or older with high blood pressure: lower than 150/90
These blood sugar goals, if you have diabetes but are not pregnant, are based on recommendations from the 2015 American Diabetes Association practice guidelines for Standards of Medical Care in Diabetes. These goals depend upon whether you have eaten recently or have not eaten recently:
- A1c: less than 7 percent
- Fasting (more than eight hours without food): 80-130 mg/dl
- Nonfasting (one to two hours after beginning a meal): less than 180 mg/dl
If you are pregnant or have other individual risk factors – age, having diabetes for a long time or heart problems – your goals may be different.
Your doctor may assign you a specific hemoglobin A1c goal. Your hemoglobin A1c is an average of how your blood sugar has been during the past three months. Your doctor also may require you to get your A1c tested every three to six months. Some local pharmacies offer this service, so ask your pharmacist if you are due for an A1c check.
Each patient is different, so your goal may differ from the standard guidelines for a number of reasons. There are also new studies coming out that could alter the standard guidelines in the near future.
Always be aware of your own health goals by checking with your health care provider. Then, when you check your blood pressure or blood sugar, you will have a better understanding of what those numbers mean. If you do not own a blood pressure cuff or blood sugar meter, most pharmacies offer manual blood pressure checks for free and blood sugar checks for a small fee.
Finally, keep a notebook with a log of your blood pressure and blood sugar readings. Write down your goals on the first or last page as a reference, and create a section dedicated to questions to ask your health care provider. This will help you remember your concerns and help your health care provider choose the best treatment plan based on your needs.
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