High blood pressure / hypertension

Update for Older People on the New Blood Pressure Recommendations

On November 10th 2015, thirdAGE published the breaking news about the new, lower blood pressure guidelines. Now the University of Utah has since issued an release that highlights the fact that for older people, there may be both benefits and drawbacks to lowering systolic blood pressure from the previous gold standard of 140 mmHG to 120 or less.

The release notes that although adults age 75 and older could potentially benefit the most from interventions based on positive results of the Systolic Blood Pressure Intervention Trial (SPRINT) because this age group carries the greatest burden of hypertension, they would be predicted to be most at risk for any potential side effects that are still under investigation.

The release quotes Mark Supiano, M.D., chief of geriatrics at University of Utah Health Care and Director of the VA Salt Lake City Geriatric Research, Education, and Clinical Center as saying “If there were a single drug with this kind of beneficial outcome, it would be a billion-dollar drug. But we can’t just treat the heart, we need to treat the whole person. We will need to exercise caution when implementing this information.”

SPRINT randomly assigned over 9,300 participants one of two blood pressure targets: less than 120 mmHg or less than 140 mmHg. Participants were age 50 years or older, at increased risk for cardiovascular disease, had a systolic blood pressure of at least 130 mmHg, and did not have diabetes or history of stroke. Blood pressure was adjusted with antihypertensive medications over the course of the study, especially during the first year. Healthy life styles were encouraged in all participants, who were monitored for a total of slightly more than three additional years.

The results from SPRINT differ from a previous large blood pressure trial on people with diabetes, which demonstrated that a blood pressure target of 120 mmHg did not significantly reduce the risk for cardiovascular events. Cheung says the difference in outcomes between these two trials may stem from SPRINT’s large sample size as well as its inclusion of more older adults and individuals with kidney disease, while excluding patients with diabetes.

“We saw great cardiovascular health improvements in just three years, but it could be even a lot more over the course of 10 or 30 years, if intense blood pressure treatment continues. Therefore, these results are very exciting and could have profound implications on blood pressure treatment in years to come.” says Cheung.

Nonetheless, he cautions that it remains to be determined how SPRINT results will influence official medical guidelines for treating hypertension.

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