The new treatment guidelines were strongly influenced by the results from SPRINT (Systolic Blood Pressure Intervention Trial), which were published in 2015. For those over 65, the goal is to achieve a systolic pressure below 130. Medication is also recommended for adults age 65 years or older with a systolic pressure of 130 or greater. The treatment target goals are also new, with a goal of reaching below 130/80 for all adults taking antihypertensive medication. The new guidelines differ from the past in recommending medication for adults with blood pressure between 130/80 and 140/90 who have any the following risk factors: diabetes, chronic kidney disease, cardiovascular disease, or a 10-year predicted cardiovascular disease risk of at least 10 percent. ![]() The current lower diagnostic threshold for hypertension diagnosis is justified by numerous large observational studies, which established that even people with a systolic pressure above 130 (or a diastolic pressure above 80) have an increased risk for heart disease or stroke. With the previous guidelines, hypertension was diagnosed in adults with blood pressure greater than 140/90, and treatment was aimed at reducing blood pressure in most patients to a systolic pressure below 140. The guidelines lower the threshold for a diagnosis of high blood pressure to 130/90. He was recently invited by JAMA Internal Medicine to comment on recent hypertension research. ![]() national hypertension treatment guidelines. Moran is the principal investigator of an NIH-funded project comparing the effectiveness and costs of U.S. ![]() To explain what the new guidelines mean for patients and clinicians, we talked with Andrew Moran, MD, an internist at Columbia University Irving Medical Center. The new guidelines lower the threshold in all patients to 130/80, and the change has prompted debate among physicians in the medical literature and in the mass media. Overnight, some 30 million more Americans had high blood pressure.įor decades, high blood pressure in most patients was defined as 140/90 mmHg or higher (the first number measures systolic blood pressure, when the heart contracts the second measures diastolic pressure, when the heart relaxes). Last November, the American College of Cardiology and American Heart Association issued the first new set of hypertension treatment guidelines since 2003.
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