The new guidelines change nothing if you're younger than 60. But if you're 60 or older, the target has moved up: Your goal is to keep your blood pressure at 150/90 or lower. If you have kidney disease or diabetes, your target used to be 130/80 or lower; now it's 140/90 or lower.
Raymond R. Townsend, M.D., director of the hypertension program at the University of Pennsylvania and a member of the panel that wrote the new guidelines, says that the change is based on the best available data from randomized controlled trials, considered the gold standard for scientific evidence.
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But every patient is different, he says. And while "some will be better off with blood pressure at 130, others whose blood pressure is running 140 to 146, and [who are] already on 11 medications, don't need to add a 12th pill to lower their blood pressure to 138. A doctor's judgment trumps guidelines."
The dissenting panel members, however, say the evidence isn't strong enough to support raising the bar from 140 to 150 for everyone older than 60.
According to Jackson T. Wright Jr., M.D., author of the minority view and director of the clinical hypertension program at University Hospitals Case Medical Center in Cleveland, it could leave older adults with untreated high blood pressure at greater risk for complications — especially for African Americans and those with additional cardiovascular risk factors.
Wright, who was also a member of the 2003 panel, supports sticking with those recommendations to treat blood pressure that is above 140/90.
"With that target, the complication rate has been decreasing over the past several decades, especially in those over age 60," he says. By following the new guidelines, "we may face a reverse in these gains."
Still, both doctors and patients worry about the side effects of blood pressure meds, particularly dizziness that can lead to falls, and how the pills interact with the other medications a patient may be taking. By adding some leeway in treating high blood pressure, patients may be able to take fewer pills, says Townsend.
As a seasoned health and wellness expert with an in-depth understanding of medical guidelines and evidence-based practices, let's delve into the key concepts discussed in the provided article. My expertise in the field allows me to provide insights and analysis of the information presented:
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New Blood Pressure Guidelines for Individuals 60 and Older: The article highlights a change in blood pressure guidelines for individuals aged 60 and older. According to Raymond R. Townsend, M.D., the director of the hypertension program at the University of Pennsylvania and a member of the panel responsible for the new guidelines, the target for this age group is now to maintain blood pressure at 150/90 or lower.
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Targets for Individuals with Kidney Disease or Diabetes: The article further notes that for individuals with kidney disease or diabetes, the previous target of 130/80 has been adjusted to 140/90 or lower.
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Scientific Basis for the Guidelines: Dr. Townsend emphasizes that these changes are rooted in the best available data from randomized controlled trials (RCTs), considered the gold standard for scientific evidence. This indicates a commitment to evidence-based decision-making in the development of health guidelines.
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Individual Variability in Treatment: Dr. Townsend acknowledges that each patient is unique, suggesting that a one-size-fits-all approach may not be suitable for everyone. He emphasizes the importance of a doctor's judgment, stating that in some cases, following the guidelines strictly may not be in the best interest of the patient.
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Dissenting Views on the Guidelines: The article introduces dissenting panel members who argue that the evidence supporting the shift from 140 to 150 for individuals over 60 is not strong enough. Jackson T. Wright Jr., M.D., who represents the minority view, expresses concern that this change may lead to untreated high blood pressure and increased risks, particularly for certain demographic groups like African Americans and those with additional cardiovascular risk factors.
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Potential Complications and Side Effects: Both doctors and patients are shown to be concerned about the side effects of blood pressure medications, such as dizziness leading to falls, and potential interactions with other medications. Dr. Townsend suggests that by allowing some flexibility in treatment, patients might be able to reduce the number of medications they need to take.
In conclusion, this information reveals a nuanced landscape in the field of hypertension management, where guidelines are subject to interpretation, dissenting opinions exist, and a balance must be struck between evidence-based practices and individualized patient care.
