New Guideline on Systolic Blood Pressure for People Aged 60 Years and Older
The American College of Physicians (ACP) and the American Academy of Family Physicians (AAFP) recently released a joint practice guideline on systolic blood pressure for people aged 60 years and older with hypertension.
Evidence showed that risk for stroke or a cardiac event is reduced when a goal is set to get someone’s systolic pressure below 150 mm Hg if they are consistently above this range. Additional benefits from setting a more aggressive (lower) systolic target rate showed little benefit in outcome results. However, the guidelines show that in some cases a lower systolic target should still be considered.
If patients have a history of stroke or transient ischemic attack or have high cardiovascular risk, physicians should consider starting or increasing drug therapy to achieve systolic blood pressure of less than 140 mm Hg to reduce risk for stroke and cardiac events. However, the authors note that this recommendation was rated weak, with moderate-quality evidence.
The guidelines also emphasize that cost burdens should be considered since some generic formulations have similar efficacy to name brand, but can lead to better adherence.
The full guidelines were published online January 17, 2017 in the Annals of Internal Medicine, but a summary will be published in the March/April 2017 issue of the Annals of Family Medicine.
