HealthDay News — According to a newly published clinical practice guideline in the Annals of Internal Medicine, two leading medical organizations are recommending a less aggressive target for the treatment of hypertension in adults 60 and older who are otherwise healthy.

The new guideline says doctors should now begin treatment when adults 60 and older have persistent systolic blood pressure at or above 150 mm Hg, to reduce their risk of cardiovascular events, stroke and death.

A less aggressive target like this offers a suitable balance of benefits and potential harms for these patients, according to the new guideline from the American College of Physicians and the American Academy of Family Physicians. Any additional benefit from more aggressive treatment is small, the groups say.

Exceptions include recommendations for adults 60 and older with a history of stroke or transient ischemic attack. Doctors should aim to achieve a systolic blood pressure of less than 140 mm Hg, to reduce these patients’ risk of recurrent stroke. 

And based on individual assessment, doctors should also consider doing the same for adults aged 60 and older who are deemed to be at high risk for cardiovascular events, according to the guidelines.

References

Qaseem A, et al. “Pharmacologic Treatment of Hypertension in Adults Aged 60 Years or Older to Higher Versus Lower Blood Pressure Targets: A Clinical Practice Guideline From the American College of Physicians and the American Academy of Family Physicians.” Ann Intern Med. 2017. doi: 10.7326/M16-1785. [Epub ahead of print]

Weiss J, et al. “Benefits and Harms of Intensive Blood Pressure Treatment in Adults Aged 60 Years or Older: A Systematic Review and Meta-analysis.” Ann Intern Med. 2017. doi: 10.7326/M16-1754. [Epub ahead of print]

Pignone M, Viera AJ. “Blood Pressure Treatment Targets in Adults Aged 60 Years or Older.” Ann Intern Med. 2017. doi: 10.7326/M17-0034. [Epub ahead of print]

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