Newspaper article International New York Times

Blood Pressure Panel Relaxes Guidelines

Newspaper article International New York Times

Blood Pressure Panel Relaxes Guidelines

Article excerpt

New guidelines suggest that people over 60 can have a higher blood pressure than previously recommended before starting treatment to lower it.

New guidelines suggest that people over 60 can have a higher blood pressure than previously recommended before starting treatment to lower it. The advice, criticized by some physicians, changes treatment goals that have been in place for more than 30 years.

Until now, people were told to strive for blood pressures below 140/90, with some taking multiple drugs to achieve that goal. But the American guidelines committee, which spent five years reviewing evidence, concluded that the goal for people over 60 should be a systolic pressure of less than 150. And the diastolic goal should remain less than 90.

Systolic blood pressure, the top number, indicates the pressure on blood vessels when the heart contracts. Diastolic, the bottom number, refers to pressure on blood vessels when the heart relaxes between beats.

Essentially, the committee determined that there was not strong evidence for the blood pressure targets that had been guiding treatment and that there were risks associated with the medications used to bring pressures down.

The committee, composed of 17 academics, was tasked with updating guidelines last formulated a decade ago. Their report was published online on Wednesday in The Journal of the American Medical Association.

Hypertension experts said they did not have a precise figure on how many Americans would be affected by the new guidelines. But Dr. William B. White, the president of the American Society of Hypertension, said it was "a huge number, for sure."

Dr. White estimated that millions of people over 60 have blood pressures between 140 and 150. Under the old guidelines they would need medication, but with the new ones they would not.

"If you get patients' blood pressure below 150, I believe you are doing as well as can be done based on scientific evidence," said Dr. Paul A. James, the chairman of the department of family medicine at the University of Iowa and a co-chairman of the guidelines committee. …

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