title: Is 60 the New 80 in Hypertension?
abstract: Since the release of 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)", much controversy has ensued over the appropriate systolic blood pressure goal for those over the age of 60 years. This guideline suggested liberalizing the target for this population to <150 mmHg, moving away from previous guidelines suggesting a target of <140 mmHg. While some national quality measures have accepted the new relaxed blood pressure goal, the American Heart Association and American College of Cardiology have not. Recently published data show that millions of adults over 60 years of age would be classified as controlled using a threshold of <150 mmHg, but not with a target of <140 mmHg. In addition, emerging randomized trial evidence suggests that targeting a systolic blood pressure well below 140 mmHg is beneficial in older adults. In light of the improved health and vitality of older adults, and the steady decline in cardiovascular and cerebrovascular mortality over recent decades, we do not think it is in good judgment to liberalize the treatment target in adults less than 80 years of age.
authors.affiliation: Denver Health Medical Center, 777 Bannock St. MC 0960, Denver, CO, 80204, USA.|Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA.
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Pflederer
authors.affiliation: Denver Health Medical Center, 777 Bannock St. MC 0960, Denver, CO, 80204, USA.|Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA.
authors.forename: Raymond O
authors.initials: RO
authors.lastname: Estacio
authors.affiliation: Denver Health Medical Center, 777 Bannock St. MC 0960, Denver, CO, 80204, USA. mkrantz@dhha.org.|Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA. mkrantz@dhha.org.
authors.forename: Mori J
authors.initials: MJ
authors.lastname: Krantz
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D001795:Blood Pressure Determination / Q000379:methods / Q000592:standards*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic / Q000379:methods / Q000592:standards
chemical_list: D000959:Antihypertensive Agents
keywords: cardiovascular disease; guidelines; hypertension; prevention