With the new guidelines, that patient will be "read the riot act" about exercise and healthy eating but the goal will be for them to bring their blood pressure down with those lifestyle changes before prescribing medications, Gandhi said.
Tighter blood pressure guidelines from US heart organizations mean millions more people need to make lifestyle changes, or start taking medication, in order to avoid cardiovascular problems.
High blood pressure accounts for the second largest number of preventable heart disease and stroke deaths, second only to smoking. Though, if patients with stage one have additional risk factors, such as a previous stroke, heart attack, diabetes or kidney disease, doctors may prescribe a medication, along with lifestyle changes.
"If you take it right as the patient walks in, it's usually higher, because he has sort of a fight or flight response so he has 10 points more but then they relax and the pressure is normal", Dr. Fabregas said.
Blood pressure of 120 over 80 is still considered normal, with any systolic pressure reading up to 129 considered "elevated".
This comes after the American Heart Association redefined guidelines for the first time in almost a decade.
Under the new guidelines published Monday, 46 percent of Americans now have hypertension compared to 32 percent under the former definition.
"We want to be straight with people - if you already have a doubling of risk, you need to know about it", said Dr. Paul K. Whelton, the lead author of the new guidelines. "It doesn't mean you need medication, but it's a yellow light that you need to be lowering your blood pressure, mainly with non-drug approaches".
Potentially deadly high blood pressure can be brought under control with a wide array of medications, many sold as relatively low-priced generics.
High blood pressure can mean serious problems with your heart. Dr. Fabregas says when the high pressure ruins those pipes, or blood vessels, the heart has to work harder to pump blood.