Hypertension Guidelines Developed for Older Adults
The American College of Physicians (ACP) and the American Academy of Family Physicians (AAFP) have just published an evidence-based clinical practice guideline on the appropriate systolic pressure target specifically for adults aged 60 years and older (published online Ann Int Med).
ACP and AAFP recommend that physicians initiate treatment in adults aged 60 years old and older with persistent systolic blood pressure at or above 150 millimeters of mercury (mm Hg) to achieve a target systolic blood pressure of less than 150 mm Hg to reduce the risk of mortality, stroke, and cardiac events.
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The guidelines were developed through “a rigorous process based on an extensive review of the highest quality evidence available” and also points out gaps in this evidence as well as suggestions for future study.
“The evidence showed that any additional benefit from aggressive blood pressure control is small, with a lower magnitude of benefit and inconsistent results across outcomes,” said Nitin S. Damle, MD, MS, MACP, president, ACP, in a press release. “Most benefits of targeting of less than 150 mm Hg apply to individuals regardless of whether or not they have diabetes.”
John Meigs Jr, MD, president, AAFP, said: “The most accurate measurements come from multiple blood pressure measurements made over time. These may include multiple measurements in clinical settings or ambulatory or home-monitoring.”
The guideline also recommended “that physicians consider initiating or intensifying drug therapy in adults aged 60 years old and older with a history of stroke or transient ischemic attack to achieve a target systolic blood pressure of less than 140 mm Hg to reduce the risk of recurrent stroke.”
They also suggest that physicians consider “initiating or intensifying pharmacological treatment in some adults aged 60 years old and older at high cardiovascular risk, based on individualized assessment, to achieve a target systolic blood pressure of less than 140 mm Hg to reduce the risk of stroke or cardiac events.”—Amanda Del Signore
