Blood Pressure Treatment Targets in Adults Aged 60 Years or Older
Authors: Michael Pignone, Anthony J. Viera
Journal: Annals of Internal Medicine (2017)

Editorials21 March 2017Blood Pressure Treatment Targets in Adults Aged 60 Years or OlderMichael Pignone, MD, MPH and Anthony J. Viera, MD, MPHMichael Pignone, MD, MPHFrom University of Texas Dell Medical School, Austin, Texas, and University of North Carolina at Chapel, Chapel Hill, North Carolina.Search for more papers by this author and Anthony J. Viera, MD, MPHFrom University of Texas Dell Medical School, Austin, Texas, and University of North Carolina at Chapel, Chapel Hill, North Carolina.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M17-0034 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Elevated blood pressure (BP) remains one of the most important causes of preventable morbidity and mortality in the United States, particularly for older adults. Almost 65% of U.S. adults aged 60 years or older have hypertension (defined as a BP ≥140/90 mm Hg or use of hypertension medication), and only about half (52.5%) have controlled BP (defined as <140/90 mm Hg). More than 15% of persons with hypertension are unaware of their condition (1).More effective identification and management of hypertension have the potential to substantially reduce cardiovascular morbidity and mortality. However, the most effective and efficient clinical strategies remain ...References1. Yoon SS, Fryar CD, Carroll MD. Hypertension prevalence and control among adults: United States, 2011–2014. NCHS data brief no. 220. Hyattsville, MD: National Center for Health Statistics; 2015. Accessed at www.cdc.gov/nchs/products/databriefs/db220.htm on 10 January 2017. Google Scholar2. Weiss J, Freeman M, Low A, Fu R, Kerfoot A, Paynter R, et al. Benefits and harms of intensive blood pressure treatment in adults aged 60 years or older. A systematic review and meta-analysis. Ann Intern Med. 2017;166:419-29. doi:10.7326/M16-1754 LinkGoogle Scholar3. Qaseem A, Wilt TJ, Rich R, Humphrey LL, Frost J, Forciea MA. Clinical Guidelines Committee of the American College of Physicians; Commission on Health of the Public and Science of the American Academy of Family Physicians. Pharmacologic treatment of hypertension in adults aged 60 years or older to higher versus lower blood pressure targets: a clinical practice guideline from the American College of Physicians and the American Academy of Family Physicians. Ann Intern Med. 2017;166:430-7. doi:10.7326/M16-1785 LinkGoogle Scholar4. James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014;311:507-20. [PMID: 24352797] doi:10.1001/jama.2013.284427 CrossrefMedlineGoogle Scholar5. Wright JT, Williamson JD, Whelton PK, Snyder JK, Sink KM, Rocco MV, et al; SPRINT Research Group. A randomized trial of intensive versus standard blood-pressure control. N Engl J Med. 2015;373:2103-16. [PMID: 26551272] doi:10.1056/NEJMoa1511939 CrossrefMedlineGoogle Scholar6. Cushman WC, Evans GW, Byington RP, Goff DC, Grimm RH, Cutler JA, et al; ACCORD Study Group. Effects of intensive blood-pressure control in type 2 diabetes mellitus. N Engl J Med. 2010;362:1575-85. [PMID: 20228401] doi:10.1056/NEJMoa1001286 CrossrefMedlineGoogle Scholar7. Richman IB, Fairley M, Jørgensen ME, Schuler A, Owens DK, Goldhaber-Fiebert JD. Cost-effectiveness of intensive blood pressure management. JAMA Cardiol. 2016;1:872-879. [PMID: 27627731] doi:10.1001/jamacardio.2016.3517 CrossrefMedlineGoogle Scholar8. Lonn EM, Bosch J, López-Jaramillo P, Zhu J, Liu L, Pais P, et al; HOPE-3 Investigators. Blood-pressure lowering in intermediate-risk persons without cardiovascular disease. N Engl J Med. 2016;374:2009-20. [PMID: 27041480] doi:10.1056/NEJMoa1600175 CrossrefMedlineGoogle Scholar9. Jaffe MG, Lee GA, Young JD, Sidney S, Go AS. Improved blood pressure control associated with a large-scale hypertension program. JAMA. 2013;310:699-705. [PMID: 23989679] doi:10.1001/jama.2013.108769 CrossrefMedlineGoogle Scholar10. Navar AM, Pencina MJ, Peterson ED. Assessing cardiovascular risk to guide hypertension diagnosis and treatment. JAMA Cardiol. 2016;1:864-871. [PMID: 27604060] doi:10.1001/jamacardio.2016.2861 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From University of Texas Dell Medical School, Austin, Texas, and University of North Carolina at Chapel, Chapel Hill, North Carolina.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M17-0034.Corresponding Author: Michael Pignone, MD, MPH, University of Texas Dell Medical School, 1912 Speedway D2000, Austin, TX 78721; e-mail, [email protected]utexas.edu.Current Author Addresses: Dr. Pignone: University of Texas Dell Medical School, 1912 Speedway D2000, Austin, TX 78721.Dr. Viera: Department of Family Medicine, University of North Carolina at Chapel Hill, 590 Manning Drive, CB 7595, Chapel Hill, NC 27599.This article was published at Annals.org on 17 January 2017. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoPharmacologic Treatment of Hypertension in Adults Aged 60 Years or Older to Higher Versus Lower Blood Pressure Targets: A Clinical Practice Guideline From the American College of Physicians and the American Academy of Family Physicians Amir Qaseem , Timothy J. Wilt , Robert Rich , Linda L. Humphrey , Jennifer Frost , Mary Ann Forciea , and Benefits and Harms of Intensive Blood Pressure Treatment in Adults Aged 60 Years or Older Jessica Weiss , Michele Freeman , Allison Low , Rochelle Fu , Amy Kerfoot , Robin Paynter , Makalapua Motu'apuaka , Karli Kondo , and Devan Kansagara Metrics Cited byPrimary Prevention of Cardiovascular Risk in Octogenarians by Risk Factors ControlMedical Overtreatment: Friend or Foe? 21 March 2017Volume 166, Issue 6Page: 445-446KeywordsBlood pressureCardiovascular diseasesDisclosureElderlyHypertensionHypotensionMedical risk factorsMorbidityMortalityRelative risk ePublished: 17 January 2017 Issue Published: 21 March 2017 Copyright & PermissionsCopyright © 2017 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...