Hypertension: New Guidelines

HypertensionOnly about six years overdue, new guidelines for treating hypertension have been released by the Joint National Committee on The Detection, Evaluation and Treatment of High Blood Pressure.  For the purpose of drug treatment, the committee increased the threshold for drug treatment of hypertension from 140/80 to 150/90 in the elderly aged 60 and older, thereby re-categorizing people with the lower blood pressure from mildly hypertensive to pre-hypertensive. 

Based on a comprehensive review of data of those treated for 3-5 years, the committee determined that drug therapy for mild hypertension did not necessarily reduce adverse health events such as heart attack, stroke and premature death. 

Critics of the new guidelines study feel that the basis for revision is specious since the benefits of treating mild hypertension can be exhibited beyond the five year time frame of the study.  They also feel that these new thresholds will lead to an all too lenient treatment of this silent killer. 

With the reduced incidence of stroke of 40% under the old guidelines, Dr. Samuel Mann author of Hypertension and You feels that this is no time to relax our watchfulness.  He feels the overtreatment of high blood pressure is due to other factors than low thresholds and over prescription of drugs.  Still others feel that the new guidelines have merit since they highlight our gaps in knowledge and discourage common over treatment. 

The committee recommended a healthy diet, weight control and regular exercise as important factors in controlling high blood pressure for all adult segments.  They failed to come up with a recommendation for people younger than 60, but suggested we stick with the old guidelines in order to be conservative.  They also had trouble defining a threshold for those who suffer from kidney disease and diabetes, but suggested a target of 140/90 for these segments which is higher than the 130/80 formerly recommended. 

The committee veered people away from beta blockers and toward thiazide type diuretics and calcium channel blockers.  Thiazide diuretics are often initially prescribed for hypertension; however studies have shown that older adults who take thiazide diuretics have a much higher risk of developing adverse metabolic events.  One in twelve adults developed hyponatremia (low blood sodium levels), hypokalemia (low blood potassium levels) or acute kidney injury.  As such, elderly patients on this medication need to be aware of the risks. 

David York Agency provides skilled home health aide services for the elderly in their home and is abreast of all the latest guidelines for seniors.  We would be happy to discuss your case with you.  Please call us at (718) 376-7755 or visit our website.  You can also follow us on Facebook, Twitter, or LinkedIn.