Dr. Pat Thomas is a cardiologist at NYPMG Hudson Valley Cardiology in Cortland Manor, New York. He has served patients throughout Westchester, Putnam and Dutchess Counties in New York since 2002. He is also the president of the American Heart Association’s Putnam County Board of Directors in New York. He and his wife, Johanna, are supporters of the Putnam County Heart Walk. Dr. Thomas has also served as chair of that event. We caught up with Dr. Thomas at the AHA’s Scientific Sessions in Anaheim this week. The big news of the week was the new high blood pressure guidelines.
Why did you come to Scientific Sessions?
Number one, getting to network with many thousands of other cardiologists to share our expertise, our clinical experiences and come up with the best way to treat patients. Second, I enjoy getting to see the late-breaking clinical science, the most up to date clinical trials that are being released at Sessions. In today’s wireless world, we can find out a lot of this information in real time even if I’m sitting at home. But here we get to discuss it with the experts who did the trials one-on-one or sometimes in small or large groups. And that’s something you can’t get unless you’re here on site. And it allows for a small group format where we can sit down with 10-20 cardiologists and discuss particular problems, and come up with solutions.
Why do you support the American Heart Association?
I’m involved in the AHA for more reasons than I can count. The most important is simply this, as a practicing cardiologist, I couldn’t do what I do on a daily basis without the support, guidance, and education provided by the American Heart Association. In particular, the journal Circulation, which we consider to be the Bible in cardiology, is published once a week and gives us the latest and greatest in science as well as practice guidelines. In addition, I have a personal reason to be involved in the AHA. Heart disease is rampant in my family at an early age on both sides, both male and female. So, it’s a personal reason, not just professional.
What do you think about the updated blood pressure guidelines announced on Monday?
The big change is a decrease in the blood pressure targets for therapy. The definition of high blood pressure, or hypertension, has changed from 140/90 to 130/80. This is a substantial expansion of the potential number of people who have hypertension in this country. So now roughly one of every two U.S. adults will have hypertension.
How does this change the way we approach talking about hypertension, diagnosing it, and treating it?
We used to think that medical therapy didn’t need to be given until 140/90, but the more recent clinical studies have shown that treating down to 120/80 yield additional benefits in terms of reducing the risk of heart attack, stroke and death, even in patients who have never had a heart attack. The guidelines also focus on managing risk. They harmonize with guidelines for cholesterol. It’s focusing more on global risk for a patient.
Does it mean you go on medication if you have 132/82?
No, it depends on other risk factors, or 10-year estimate risk of developing heart problems of over 10 (as measured by the ASCVD Risk Estimator tool). In those cases, we might recommend starting medicines, but in the lower risk categories, we’ll most likely start with lifestyle recommendations which haven’t changed a lot over the years — and include sodium reduction, exercise, moderating alcohol consumption and increasing fruits, vegetable and fiber in the diet.
For more information on the new guidelines, visit www.heart.org/highbloodpressure.