Adults aged 60 or over only need to take medication if their BP readings exceed 150/90

According to recent research, fewer people should be taking medications for controlling hypertension. The report, published recently in the Journal of the American Medical Association, suggested that adults aged 60 or over only need to take medication if their BP readings exceed 150/90. This is higher than the current guideline which is set at 140/90.

The report also raised the bar for kidney and diabetes patients younger than 60. Currently they receive treatment if their blood pressure exceeds 130/80, but this research indicates that 140/90 should be the point at which they should have medications.

The recommendations are based on clinical evidence which showed that patients received no additional benefits from the stricter guidelines. According to the report’s author Dr. Paul James, it became clear that 150 was the best number.

The panel’s conclusions have been met with caution in some quarters, with the AHA (The American Heart Association) expressing concern that relaxing the existing recommendations might expose more people to inadequately controlled hypertension. In November the AHA and the ACC (American College of Cardiology) released their own treatment guidelines for hypertension. They also issued new guidelines for treating high cholesterol that could involve an increased number of people taking statins.

The U.S. National Heart, Lung and Blood Institute is also set to update the last set of guidelines issued in 2003. After reviewing the recent research, the institute decided to forge ahead and recommend that seniors should only be given medication if they have the higher blood pressure reading. This is based on both the clinical evidence as to the medical benefit, as well as concern over the high cost of drugs, as well as the potential for negative impact of drug interactions. Since elderly people tend to have other diseases associated with their age, it’s not uncommon to see people who are taking 10 kinds of medications. If there is no evidence to support the blood pressure meds improving health, then it seems unnecessary to add these into the mix.

While the definition of high blood pressure remains the same – that of 140/90, lifestyle changes would be more appropriate for people with high blood pressure readings that fall below the levels at which medication is needed. So those with a blood pressure reading of between 140 and 159 systolic pressure and a diastolic pressure of 90 to 99. Any higher than that and patients should be treated with a combination of lifestyle changes and medication, until hypertension is reduced.

At no point should patients take themselves off prescribed medications, since the recommendations are intended for physicians to adapt to their patients’ individual needs. Staff cardiologist Dr. Curtis Rimmerman of the Cleveland Clinic in Ohio believes the guidelines may mean he will relax some blood pressure goals particularly among elderly patients who take lots of medications. Many other clinicians will no doubt adopt a similar strategy going forward.

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