Dear Savvy Senior: What numbers constitute high blood pressure? I use to be pre-hypertensive, but they keep changing the guidelines, so I’m not sure where I fit in now. — Approaching 60

Dear Approaching: If you’re unsure what your blood pressure levels should be, you’re not alone. Recent changes in the hypertension guidelines made by the American Heart Association and the American College Cardiology mean that roughly 30 million more Americans than previously thought are now considered to have high blood pressure (hypertension).

According to the new guidelines, anyone with a blood pressure reading above 130/80 is considered to have high blood pressure.

Previously, those with a blood pressure reading between 120/80 and 139/89 would have been put in the prehypertension category and wouldn’t have been considered hypertensive until they got to 140/90.

But the new guidelines eliminate the prehypertension category, putting everyone with systolic pressure readings (top number) between 120 and 129 and a diastolic reading (bottom number) below 80 in a new “elevated” category. And those with a reading of 130/80 or higher fall in some stage of hypertension.

Get checked

Millions of Americans with high blood pressure don’t know they have it because it usually has no outward signs or symptoms. But high blood pressure, over time, can damage your arteries and increase your risk for heart disease, stroke, kidney damage and even dementia. Everyone over the age of 40, as well as those younger with risk factors for hypertension should get their blood pressure checked at least once a year.

If you find that your blood pressure numbers fall in the “elevated” category, take steps to get it under control. Lifestyle changes like eating a healthy diet, losing weight, exercising, watching your salt intake, quitting smoking, and cutting back on alcohol is often all you need to get it back to normal.

Even if your blood pressure numbers are in the “stage 1” category, lifestyle changes are recommended first, unless you’have other risk factors. Then medications may be prescribed.

But if your blood pressure falls in the “stage 2” or higher category, the medication and lifestyle changes are suggested.

There are several different kinds of drugs used to lower blood pressure. It usually makes sense to start with the oldest, safest and least expensive drug: diuretics, or water pills, such as chlorthalidone or hydrochlorothiazide. But these meds can drive up blood sugar levels, so if you have type 2 diabetes or are at risk of it, your doctor may prescribe another drug, such as an ACE inhibitor, ARB or calcium channel blocker.

For more information, visit Heart.org/HBP.

Jim Miller is a contributor to NBCTV’s “Today” program and author of “The Savvy Senior.” Send your questions to Savvy Senior, P.O. Box 5443, Norman, OK 73070; or visit savvysenior.org.