VA Research Supports More Flexible Goals in Older Patients
By Brenda L. Mooney
Now, based on critical research from the Portland, OR, VA Healthcare System, two major physicians group have rejected that mentality in recent guidelines. Those documents suggested that systolic blood pressure below 150 mm Hg is sufficient for most patients older than 60 to reduce their risk of mortality, stroke and cardiac events.
The evidence-based clinical practice guideline on the appropriate systolic blood pressure target for adults 60 years old and older with hypertension was developed jointly by the American College of Physicians (ACP) and the American Academy of Family Physicians (AAFP) and published in Annals of Internal Medicine.1
The new document has provoked controversy because many other guidelines recommend that all adults, at least to age 80, seek to lower systolic blood pressure to below 140 mm Hg. In addition, the high-profile 2015 SPRINT study urged that the target be even lower.
Background information in the guidelines article, authored by a team from the American College of Physicians and University of Pennsylvania Health System, noted that about 65% of those older than 60 have hypertension in the United States, compared to an overall adult rate of about 29%.