By Elizabeth O'Brien
New guidelines could bring a sea change in the way that millions of people age 60 and over are treated for high blood pressure. If doctors put them into practice, it could mean that fewer older people will take medication to control the condition.
Currently, many people whose blood pressure registers above 140/90 take medication in order to lower their pressure below that target. The new guidelines, published on Wednesday on the website of The Journal of the American Medical Association, increase the target blood pressure in people 60 and over to a top number of less than 150 and in turn, raise the threshold for taking medication in this population. (The goal for the bottom number remains less than 90.)
A New York Times story on the new guidelines quoted an expert who estimated that millions of people age 60 and over have blood pressures between 140 and 150 and thus could stop taking medication under the new guidelines.
Hypertension, or high blood pressure, remains one of the most important preventable contributors to disease and death, wrote the 17-member committee of doctors and academics, which formulated the new guidelines after an extensive review of randomized controlled trials. Drug treatment can help alleviate the risk of heart attack, stroke, renal failure and death from this condition.
However, hypertension medications can have side effects that counteract some of the benefits, including weakness, leg cramps, fatigue, attacks of gout, and impotence, according to the American Heart Association.
The blood-pressure target for those younger than 60 remains less than 140/90. The committee noted, however, that that target isn’t well-supported by evidence, because studies have tended to focus on older people, who are more vulnerable to heart failure and stroke.