New Israeli Guidelines Lower Blood Pressure Targets to Improve Health Outcomes
Hypertension affects approximately 25% to 30% of the adult population in Israel, with prevalence rising to about 50% among men and 60% among women aged 65 and older. Despite its high occurrence, many neglect regular blood pressure monitoring because hypertension is typically symptomless, earning it the nickname "the silent killer." Without early diagnosis and treatment, high blood pressure can cause serious damage to vital organs such as the heart, kidneys, and brain, leading to conditions like coronary artery disease, heart attacks, heart failure, kidney failure, and strokes.
Recently, the Israeli Medical Association, together with ten professional societies, published updated national guidelines that represent a significant shift in how hypertension is diagnosed, monitored, and treated. While the diagnostic threshold remains at 140/90 mmHg, the new treatment goal is to maintain blood pressure below 130/80 mmHg, and in some cases, even as low as 120/70 mmHg under careful medical supervision. This change is based on evidence showing that better blood pressure control reduces the risk of cardiovascular and renal complications.
The guidelines also introduce a new category called "elevated blood pressure," defined as systolic readings between 130-139 mmHg or diastolic between 80-85 mmHg. Individuals in this group, who do not yet meet the criteria for hypertension, are advised to implement lifestyle changes such as reducing salt intake, exercising regularly, losing weight, avoiding smoking and alcohol, and adopting a healthy diet. For patients with additional risk factors like diabetes or kidney disease, early medication may be necessary.
Another important update emphasizes the value of home blood pressure monitoring and 24-hour ambulatory monitoring to obtain accurate readings, as clinic measurements can be affected by white-coat hypertension or masked hypertension. Patients are instructed to follow specific protocols for home measurements to ensure reliability.
Dr. Yehoshua (Shuki) Leshem, a hypertension specialist and clinic director in northern Israel, highlights that hypertension is not limited to older adults; younger people with risk factors and those experiencing stress or post-traumatic conditions are also vulnerable. Advances in treatment now include new drug classes targeting aldosterone-related mechanisms, improving options for patients with resistant hypertension. Overall, the guidelines stress the importance of regular monitoring and personalized treatment to prevent severe complications and promote long-term health.
