Systolic Blood Pressure Goals to Reduce Cardiovascular Disease Among Older Adults

• Type of Material: Article
• Authors: Paul Muntner, University of Alabama Birmingham; Barrett Bowling, Emory University; Daichi Shimbo, Columbia University
• Language: English
• Date: 2014-08-01
• Publisher: Lippincott, Williams & Wilkins
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2014 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.
• Final Published Version (URL): http://dx.doi.org/10.1097/MAJ.0000000000000314
• Title of Journal or Parent Work: American Journal of the Medical Sciences
• ISSN: 0002-9629
• Volume: 348
• Issue: 2
• Start Page: 129
• End Page: 134
• Grant/Funding Information: Source of funding: None.
• Keywords: General & Internal Medicine; HYPERTENSION; Life Sciences & Biomedicine; Hypertension; Medicine, General & Internal; Blood pressure; Elderly; FRAILTY; Guidelines; AGE; Frailty; MORTALITY; PREVALENCE; AWARENESS; Science & Technology; TRENDS
• Research Categories: Health Sciences, Medicine and Surgery

Abstract

The 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults Report From the Panel Members Appointed to the Eighth Joint National Committee (JNC 8) was recently published. This guideline recommended that older adults (≥60 years) without diabetes or chronic kidney disease with systolic blood pressure (SBP) ≥150 mm Hg or diastolic blood pressure (DBP) ≥90 mm Hg be initiated on antihypertensive medication with a treatment goal SBP/DBP <150/90 mm Hg. In contrast, the previous 3 JNC guidelines recommended treatment for these individuals be initiated at SBP/DBP ≥140/90 mm Hg with goal SBP/DBP <140/90 mm Hg. In this article, we review randomized trials of antihypertensive medication and observational data on SBP and DBP with cardiovascular outcomes among older adults, possible explanations underlying the different findings from these randomized trials and observational studies, and contemporary antihypertensive treatment patterns among older U.S. adults. In closing, we highlight future research needs related to hypertension and outcomes among older adults.