Two top physician groups are recommending a less aggressive threshold for beginning treatment of high blood pressure with medication in older adults in good health.
A recently issued guideline from the American College of Physicians (ACP) and the American Academy of Family Physicians (AAFP) recommends that doctors start hypertension drugs in adults aged 60 years and older who have persistent systolic blood pressure at or above 150 mm Hg to reduce the risk of mortality, stroke and cardiac events.
Before, the threshold was set at 140 mm Hg.
However, the groups are recommending that physicians consider increasing drug treatment for seniors with a history of stroke or transient ischemic attack – also known as a mini-stroke – to achieve a systolic blood pressure of less than 140 mm Hg. Seniors at high cardiovascular risk should also be considered for intensified drug treatment to reach a systolic blood pressure of less than 140 mm Hg to cut the risk of cardiac events and stroke.
ACP and AAFP also suggest that whenever possible, doctors prescribe generic drugs rather than name-brand formulations.
Due to a lack of evidence, the medical groups did not set targets for diastolic blood pressure.