Dr. Daniel W. Jones, M.D., FAHA — Professor Emeritus and former Dean of the University of Mississippi School of Medicine — joins us to break down the American Heart Association’s new high blood pressure guidelines. As chair of the committee that wrote them, he explains why 130/80 is the new target, the surprising link between blood pressure control and lower dementia risk, why an arm cuff beats your smartwatch, and the simple lifestyle changes that make a difference. Informational only — always consult your clinician.
Jeffrey Snyder, Broadcast Retirement Network
Joining me now is Dr. Daniel Jones. Dr. Jones, it’s so great to see you. Thanks for joining us this morning.
Daniel W. Jones, M.D., FAHA , University of Mississippi School of Medicine & American Heart Association
Thank you for having me today and thanks for your interest in high blood pressure.
Jeffrey Snyder, Broadcast Retirement Network
Yeah, look, as I alluded to during our talk in the green room, it’s an important topic. I think cardiovascular disease, as you will get into, is still prevalent in our society. We need to do a better job, so I’m very interested in helping reduce my own cardiovascular risk, but also I’m sure the audience is as well.
So let’s start talking about high blood pressure. I want to get into the first thing I noticed from the study, and this surprised me. It probably didn’t surprise me, doctor.
One in three U.S. adults with high blood pressure may need medication. I want to get your reaction to that.
Daniel W. Jones, M.D., FAHA , University of Mississippi School of Medicine & American Heart Association
We’re asking more and more people to take medication for control of their blood pressure. Part of that is because of evolving evidence. We’re asking more people to pay attention to their blood pressure and to get their blood pressure to a lower goal.
130 over 80 is the magic number now, and for most of your audience, it will be that top number, the systolic number that they really need to pay attention to, the 130, and so more and more people are eligible for high blood pressure medication. The good news is that we have lots of good medications that can lower blood pressure, not hard on the body and not hard on the pocketbook.
Jeffrey Snyder, Broadcast Retirement Network
Yeah, and we’re going to talk about that in a second. I should have asked you this from the outset, so I apologize to both you and the audience. Let’s talk about high blood pressure.
Why is it, I’m assuming just anecdotally, that it’s the force by which the blood goes through your veins and cardiovascular structure, but by definition, what are we talking about here?
Daniel W. Jones, M.D., FAHA , University of Mississippi School of Medicine & American Heart Association
Yeah, so let me just point out it’s through the arteries and not the veins. We get those confused all the time.
Jeffrey Snyder, Broadcast Retirement Network
I get those confused. I’m easily confused.
Daniel W. Jones, M.D., FAHA , University of Mississippi School of Medicine & American Heart Association
It is indeed the pressure that’s inside of our blood vessels and it has an impact on all of our organs. It impacts our brains. It impacts the function of our heart.
It impacts our kidneys. It impacts the legs and so forth. It’s really an important issue.
About 70% of people who are age 65 or older in America have high blood pressure. It’s a very, very common problem. It is the most common modifiable risk factor for cardiovascular disease and the one that can make a big difference if we manage it properly.
Jeffrey Snyder, Broadcast Retirement Network
Dr. Jones, what would cause us to have, I’m age 54, so I’m not in that age category yet, but I will be hopefully, God willing, and what trigger, is it diet? Is it just the natural aging process? What triggers the high blood pressure?
Daniel W. Jones, M.D., FAHA , University of Mississippi School of Medicine & American Heart Association
Let me be clear, it is not a part of the natural aging process. We’ve felt that perhaps it might be for a long time because almost all Americans as they age get high blood pressure, but we’ve come to understand that it is a pathophysiologic, an abnormal thing that happens to us as we age. In societies that are very primitive, where they don’t eat salt very much, they don’t gain weight as they get older, high blood pressure is very uncommon.
It’s common in almost all societies in the world today because we all, now the whole world eats like America, eat too much and eat too much salt. Genetics has a big role in this. There are a few people who are not genetically disposed to have high blood pressure, but those are uncommon.
The genetics of high blood pressure are complex because it’s many genes that are involved in high blood pressure, and almost all of us have some genetic predisposition to high blood pressure, but it’s that diet and lack of exercise, gaining weight, too much sodium, and something unpopular, too much alcohol, all of that affects high blood pressure.
Jeffrey Snyder, Broadcast Retirement Network
Well, when they’re watching football games, that’s a fun exercise, right? Pun intended, to sit there and tailgate and have some fun, but in all seriousness, doctor, it sounds like a lot of these are lifestyle changes that any and all of us can make at any age.
Daniel W. Jones, M.D., FAHA , University of Mississippi School of Medicine & American Heart Association
Yeah, so I don’t want to be confusing here, but I want to be sure that the message I get across is one that says we can do a lot with lifestyle therapy, and by the way, watching football is not good exercise, but it is important that we all do the best we can, the best we can with lifestyle, so the less sodium we eat, that’s salt, and now we know the less alcohol we take in, the better our weight is, all of that contributes to improved blood pressure, but if we need medicine, we shouldn’t be afraid of it.
We need to focus on that goal of a systolic blood pressure of less than 130, and if we need medication to get there, your clinician can help you find one that is safe and easy for you to take.
Jeffrey Snyder, Broadcast Retirement Network
So let’s talk about the different types of or the types of medicines that are available, you know, you and I are both old enough to know that science has come a long way, modern technology has come a long way, there’s a lot of options, and they, I would presume, have limited side effects or side effects that are reasonable given what they provide in terms of benefit.
Daniel W. Jones, M.D., FAHA , University of Mississippi School of Medicine & American Heart Association
When I began practicing medicine 50 years ago, there were not very many friendly medicines available. The medicines made people feel bad when they took them. Now, today, we have four classes of medication that we advise patients consider taking, that their clinicians consider giving them, that are safe and really have very few side effects in most people, because we have choices.
We have really dozens and dozens of medications we can choose from. If a patient has some side effects on the first attempt at a medication, there are other medications that can be used instead. Almost all of us can find a pathway to control blood pressure that doesn’t limit the way we feel, gives us longer, not just longer lives, but healthier lives and feel better lives as well.
Jeffrey Snyder, Broadcast Retirement Network
On the subject of blood pressure, I know we’ve been talking about blood pressure, but measuring blood pressure, it’s obtainable for, or attainable, I guess is the right word, for everybody in America to have their blood pressure taken. It’s available through your clinician, but also there are blood pressure monitors, and hey, there are now devices that you can wear on your wrist, on your finger, that do all that work. So, really, anyone today, at any age, can go out and test their blood pressure on a regular basis.
Daniel W. Jones, M.D., FAHA , University of Mississippi School of Medicine & American Heart Association
Anyone can get their blood pressure measured, and we can measure blood pressure at home, but let me advise people to avoid those things that we wear on our wrist for measuring blood pressure. The watch is not yet ready for prime time. I mean, they are snazzy.
They look good on the wrist, but they’re not very accurate at measuring blood pressure, but at your drug store or at your box store, you can buy a blood pressure cuff for about $35 or $45 that’s accurate, goes on the arm, measures from the brachial artery on the arm, and they’re accurate to be used at home, and there are instructions that come with these to tell people how to use those, and of course, you can go to see your own clinician to get your blood pressure measured as well.
No one has an excuse in America for not measuring their blood pressure.
Jeffrey Snyder, Broadcast Retirement Network
It just seems so easy, but yet, I don’t know why. Why do you think Americans, why do you think we all struggle doing the right things, doctor? It’s, you know, because we’re only on the planet for a certain period of time.
We can control a lot of those factors.
Daniel W. Jones, M.D., FAHA , University of Mississippi School of Medicine & American Heart Association
We’re stubborn. We are. We are.
We are, and Americans, I’m afraid to say, are uniquely stubborn. You know, we have higher obesity rates than any other country in the world. One analogy that I like to point out, we have more deaths in children from guns than any country in the world, and it’s because we insist on our independence and on our individual rights, and it’s hard for us to make group decisions that are good for everyone.
That makes it a little bit harder for us to consume healthy medical information and make good decisions for ourselves, so if we hear, well, gee whiz, this guy that I heard on the podcast says I should drink less alcohol. What does he know about me? And, you know, it’s easy for people just to ignore the words that come from good, strong evidence in science that could make them have stronger and healthier lives.
Jeffrey Snyder, Broadcast Retirement Network
Yeah, fact-based information is certainly important. I do want to give you an opportunity. I know you were on the Guideline Committee to help write, I mean, it takes a village to write the cholesterol, or excuse me, the blood pressure guidelines.
Any other things that maybe you can tease out of the great work being done at the American Heart Association? I just want to give them a little shout out.
Daniel W. Jones, M.D., FAHA , University of Mississippi School of Medicine & American Heart Association
Yeah, so I’ll brag on myself for a minute and say I was the chair of that 28-member committee that wrote this guideline, and it is a good guideline, and I’ll say it’s practical. Yeah. It’s one that doesn’t ask us to jump through a lot of hoops.
It says measure your blood pressure, and if your blood pressure is on the high side, then watch your diet and exercise a little bit and make yourself healthier. Stay in touch with your own clinician and get your blood pressure down to 130 over 80. Now, here might be the most important thing that I’m going to say to your audience.
One of the new things in the guideline is the information that says if you measure your blood pressure and if you control your blood pressure, your risk for not only heart disease and kidney disease and stroke is reduced, your risk for dementia is reduced as well. What good news for older Americans that there is a way to reduce your risk for dementia, and that is to control your blood pressure.
Jeffrey Snyder, Broadcast Retirement Network
A shout out and kudos to you, and I’m sure to your fellow committee members. Also, I know you’re Professor Emeritus and Dean at University of Mississippi Medical School. Anything you can tell us about the future clinicians that you’re teaching that are coming into the American medical system?
Daniel W. Jones, M.D., FAHA , University of Mississippi School of Medicine & American Heart Association
Yeah. So, I will say that I am hopeful about the future because of the good doctors that we’re training these days. They’re going to do a good job of helping take care of Americans as we get older and older and live longer and longer.
And our American healthcare system is not perfect, but we are still training good physicians to take care of our patients.
Jeffrey Snyder, Broadcast Retirement Network
Yeah. Well, doctor, kudos to you again. And look, I grew up watching Marcus Welby, and I just finished watching House.
Hopefully, the clinicians are not necessarily like Dr. They’re as smart as Dr. House, but maybe not as ornery as Dr. House. We’re going to have to leave it there, Dr. Jones. Always great to see you.
Thanks for joining us. Thanks for your great work, and we look forward to having you back on the program again very soon, sir.
Daniel W. Jones, M.D., FAHA , University of Mississippi School of Medicine & American Heart Association
Thanks so much.
