Higher blood pressure threshold advised for older patients

Medical experts have published new guidelines for the treatment of hypertension. Providers are now encouraged to raise the blood pressure threshold for prescribing medication for people over 60.Ray Townsend, who helped write the guidelines, runs the University of Pennsylvania’s hypertension program. Clinical trials have shown medications for older patients should be prescribed more conservatively than in the past, he said.

“Someone who doesn’t have kidney disease or diabetes, who is 60, we recommended a treatment goal and a diagnosis goal at 150 as opposed to 140,” Townsend said. “This is a substantial departure from the previous documents in terms of the recommendations for when to diagnose high blood pressure and to what degree to treat it.”

Ellie Kelepouris, the chief of nephrology and hypertension at Drexel University’s department of medicine, said she is worried about some of the recommended changes.

The impact of leaving higher blood pressures untreated is untested, she said.

“From a population level, I do really have a few concerns because allowing blood pressure goals to be higher than stated previously may actually translate into higher blood pressures in our patients, both in the city of Philadelphia and nationwide as well,” she said.

“The guidelines are much simpler than they’ve been in the past,” said Crystal Gadegbeku, chief of nephrology and kidney transplantation at Temple University.

“What’s nice about the report is they decided to use the best evidence using randomized control trials to come up with the guidelines so physicians can feel pretty confident this is the best information we have,” she said.

Hypertension affects 40 percent of adults and 47 percent of African Americans in Philadelphia.