New hypertension guideline discussed for older adults

Clinicians caring for older adults with hypertension should be mindful of the specific blood pressure (BP) goals proven to reduce cardiovascular disease events, while adopting the new 2017 American College of Cardiology/American Heart Association (ACC/AHA) hypertension guideline, according to an article published online May 20 in the Journal of the American Geriatrics Society.

04 jun 2018--William C. Cushman, M.D., and Karen C. Johnson, M.D., M.P.H., from the University of Tennessee Health Science Center in Memphis, discuss the 2017 ACC/AHA hypertension guideline in the context of caring for older adults with hypertension.
The authors note that the ACC/AHA hypertension guideline is primarily based on systematic reviews and meta-analyses. Consequently, the classification of BP, thresholds for initiating drug therapy, and treatment goals are not identical with specific levels proven in randomized controlled trials. When caring for older adults, it is important for physicians to be mindful of the specific BP goals proven to reduce cardiovascular disease events in this population. They should also be attentive to proper BP measurement techniques; encourage non-pharmacologic interventions; and monitor patients for concomitant conditions, adverse drug effects, and complications of elevated BP.
"Adjustments to therapy and goals may be necessary as older adults become increasingly frail, cognitively impaired, or institutionalized, or have a limited life expectancy, although many frail older adults will still benefit from appropriate antihypertensive non-pharmacological and drug therapy," the authors write.
One author disclosed financial ties to the pharmaceutical industry.

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