High blood pressure is a common disease. The blood flows through arteries at a higher pressure than normal. In the United States, high blood pressure or hypertension affects 29 percent of the adult population. The traditional threshold for the systolic pressure or the upper reading in which doctors consider prescribing treatment is 140 millimeters of mercury (mm Hg).
The American Academy of Family Physicians (AAFP) and the American College of Physicians (ACP) now recommends that treatment should be started in adults aged 60 and older if their systolic pressure is 150 mm Hg or higher to reduce the risks of stroke, cardiac events and death.
A new guideline has been issued by the two groups following evidence review of the benefits and harms of higher versus lower blood pressure thresholds for treatment of high blood pressure in individuals aged 60 and above. A systematic review has been carried out by the groups to arrive at the new guidelines. The review involved randomized controlled trials for observational studies and primary outcomes. Studies published from the start of the database records to January 2015 and updated the list with a search up to September of 2016.
Evidences were evaluated by analyzing deaths from all causes together with harms, illness and deaths linked to major cardiac events and stroke including fatal and non-fatal heart attacks and sudden cardiac death. The evidence is not enough to make recommendations about diastolic blood pressure targets or the lower reading of blood pressure as reported in Medical News Today.
The new guideline on high blood pressure states that people with history of stroke or heart attack should aim for a target of systolic pressure of 140, the lower limit of what is considered to be high blood pressure or hypertension. In people without these risk factors, treatment to achieve a number below 150 is the goal. If their numbers fall between 140 and 150, it is not worth treating at all, although many doctors consider these numbers to be high.
Dr. Devan Kansagara, an internist from VA Portland Health Care System and co-lead of the analysis of the studies, states that while aiming below 140 or even below 130 may reduce the chance of heart attack, stroke and other cardiac problems in some, it does not seem to change the overall quality of life or death rate. The American Heart Association has remained firm on its recommendation to treat older adults once their blood pressure hits 140 mm Hg according to an article by Fox6 Now.
