But Carey, professor of medicine and dean emeritus at the University of Virginia School of Medicine, said several intensive studies since 2015 show treating older adults to a lower blood pressure goal is beneficial.
“You have to escalate the treatment slower and monitor any side effects,” he said. “But it’s true there is benefit to treating ambulatory, older subjects.”
The guidelines say it can be lifesaving: “BP lowering therapy is one of the few interventions shown to reduce mortality risk in frail older individuals.” Men and women age 65 to 74 under the new classification will see high blood pressure rates increase by 13 percent and 12 percent, respectively.
Here are how some other groups will be affected by the new measurements:
— High blood pressure rates could nearly triple among men age 20 to 44 – up to 30 percent from 11 percent. Women in that age group will see their rates almost double, to 19 percent from 10 percent.
— Roughly three-quarters of men between 55 and 74 could be diagnosed with high blood pressure.
— Black and Hispanic men will experience a 17 percent increase in rates. Asian men will see a 16 percent increase.
The new classifications and recommendations are specific in how they determine who is at risk and what they should do about it, Jamerson said.
Doctors should use a “risk calculator” to determine a patient’s risk of heart disease or stroke over the next 10 years. That assessment, combined with the other recommendations, can prompt more thorough doctor-patient conversations to determine whether lifestyle changes alone can help, or if medicine is needed as well.
“These new guidelines give patients a voice because it gives them an opportunity to ask healthcare providers, ‘What’s my risk?’” Jamerson said. “Consumers should be getting an explanation. Physicians ought to be calculating risk as they think about how to treat.”
Paul Whelton, M.D., chaired the committee that wrote the new high blood pressure guidelines.
