Threshold unchanged for diagnosing hypertension

China will not lower its high blood pressure range as suggested by a recent clinical guideline, the top health authority said on Tuesday, handing the final verdict on a hotly-debated issue that sent jitters across a sizable population teetering on the brink of high blood pressure.

However, experts have also recognized that in a country with over one-fifth of adults already living with the condition, expanding awareness of healthy lifestyles and early prevention among at-risk groups is vital to reduce related deaths.

Last week, the National Center for Cardiovascular Diseases and the Chinese Medical Doctor Association jointly released a clinical practice guideline for hypertension management, suggesting resetting the diagnosed threshold for high blood pressure to 130/80 millimeters of mercury, down from the current trigger of 140/90.

Han Yaling, an academician with the Chinese Academy of Engineering and a noted cardiology expert, said during an event marking the document's release that decreasing the threshold reflects an emphasis on stepping up early prevention, so as to avoid missing a key window of opportunity to rein in the occurrence of potentially deadly cardiovascular diseases.

The guideline said there is an estimated 243 million people with their blood pressure hovering around the contentious range of 130 to 139/80 to 89, and the majority are aged 18 to 54 years old.

"Even though lowering the threshold will result in an increase in high blood pressure patients and incur expenses on early treatment, costly fees spent on much more serious comorbidities such as stroke, heart attack and poor kidney function will be much lower and the quality of patients' lives can be improved," said Han during the event.

The news has prompted many people to get their blood pressure checked.

A retiree in Zhejiang province, surnamed Huang, said he managed to lower his blood pressure from 140/90 to around 125/85 after a year of regular workouts. "At the new cutoff, I have high blood pressure again," he said. "I feel a bit frustrated but have to keep exercising to stay fit."

In response to the heated discussion, the National Health Commission said on Tuesday evening that the definition of adult hypertension remains unchanged at having three blood pressure readings taken on different days that are higher than 140/90.

It added that protocols or expert consensus released by institutions or industry associations are merely research outcomes, and will not be adopted as uniform diagnostic standards.

Most health experts have agreed with sticking to the current threshold for high blood pressure, for lack of robust evidence on the benefits of making adjustments and concerns over the capacity of grassroots medical systems.

Zhang Xinhua, president of the World Hypertension League, said that most high-quality clinical research shows that only patients with blood pressure of 140/90 or higher should take medication to reduce the risk of cardiovascular illnesses.

"For individuals whose blood pressure reading is lower than the number, healthy lifestyles such as cutting back on salt, exercising, quitting smoking and limiting alcohol consumption, are the most effective ways to manage blood pressure," she said.

Zhang added that under the current rule, China already has a massive number of high blood pressure patients. At present, about 50 percent of patients are aware of their condition, only 40 percent are on treatment and 15 percent have their disease under control.

"The healthcare system is already under immense pressure to detect patients who do not know their condition yet and provide effective therapies," she said. "If we allow groups who might not benefit from treatment to further strain limited healthcare resources, those with more severe symptoms might lose the opportunity to be diagnosed and treated."