Are the New Blood Pressure Guidelines for You?

People older than 60 should strive for blood pressure 149/90, according to new hypertensionguidelines recently published in the Journal of the American Medical Association. The previous goal for the “top” (systolic) number was 140 (the “bottom” [diastolic] number hasn’t changed). Furthermore, the committee increased the threshold for treatment for diabetic and kidney-disease patients to 140/90 (from 130/90).

After a five-year review, the guidelines committee found no strong evidence to support setting the earlier blood pressure targets, which often required medications with side effects or risks.

The new blood pressure guidelines may allow patients in the so-called “pre-hypertension” blood pressure range to be released from blood pressure treatment.

The committee recommended adjusting the kinds of medications recommended for different patient groups, tending toward starting with a certain type of diuretic (thiazide) and adding other medication as needed and with care. The authors also emphasized the importance of continued appropriate aerobic activity, maintaining a healthy weight and good nutrition as additional strategies to lower blood pressure.

It’s important to note that the new blood pressure guidelines don’t have the approval of the usual commentators from the American College of Cardiology and the American Heart Association’s professional groups. In the coming months, perhaps more professional physician societies will weigh in on the updated guidelines. This will help further clarify the recommendations and enhance patients’ treatment and reduce cardiovascular risk.

The new blood pressure guidelines can serve as another sounding board, but should not replace clinical judgment for individualized patient care or ongoing discussions with your personal physician.

This post was written by David Friedman, MD, chief of cardiology/congestive heart failure service at Franklin Hospital.

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