Pharmacologic Treatment of Hypertension in Adults Aged 60 Years or Older
Authors: Devan Kansagara, Timothy J. Wilt, Jennifer Frost, Amir Qaseem
Journal: Annals of Internal Medicine (2017)

Letters15 August 2017Pharmacologic Treatment of Hypertension in Adults Aged 60 Years or OlderDevan Kansagara, MD, MCR, Timothy J. Wilt, MD, MPH, Jennifer Frost, MD, and Amir Qaseem, MD, PhD, MHADevan Kansagara, MD, MCRFrom Portland Evidence-based Synthesis Program and Portland VA Medical Center, Portland, Oregon; Minneapolis VA Center for Chronic Disease Outcomes Research and University of Minnesota School of Medicine, Minneapolis, Minnesota; American Academy of Family Physicians, Leawood, Kansas; and American College of Physicians, Philadelphia, Pennsylvania., Timothy J. Wilt, MD, MPHFrom Portland Evidence-based Synthesis Program and Portland VA Medical Center, Portland, Oregon; Minneapolis VA Center for Chronic Disease Outcomes Research and University of Minnesota School of Medicine, Minneapolis, Minnesota; American Academy of Family Physicians, Leawood, Kansas; and American College of Physicians, Philadelphia, Pennsylvania., Jennifer Frost, MDFrom Portland Evidence-based Synthesis Program and Portland VA Medical Center, Portland, Oregon; Minneapolis VA Center for Chronic Disease Outcomes Research and University of Minnesota School of Medicine, Minneapolis, Minnesota; American Academy of Family Physicians, Leawood, Kansas; and American College of Physicians, Philadelphia, Pennsylvania., and Amir Qaseem, MD, PhD, MHAFrom Portland Evidence-based Synthesis Program and Portland VA Medical Center, Portland, Oregon; Minneapolis VA Center for Chronic Disease Outcomes Research and University of Minnesota School of Medicine, Minneapolis, Minnesota; American Academy of Family Physicians, Leawood, Kansas; and American College of Physicians, Philadelphia, Pennsylvania.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/L17-0286 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We thank Dr. Rabi and colleagues for their comments and careful review of the guideline (1) and accompanying systematic review (2). Clinical guidelines from the American College of Physicians and the American Academy of Family Physicians are based on the best available evidence (2) and meet the Guidelines International Network's and Institute of Medicine's standards for guidelines (3, 4). We wholeheartedly agree that there are important differences among the studies addressing hypertension treatment goals. Dr. Rabi and colleagues point out that blood pressure measurement techniques are 1 source of clinical heterogeneity among the studies, but many other differences ...References1. Qaseem A, Wilt TJ, Rich R, Humphrey LL, Frost J, Forciea MA; Clinical Guidelines Committee of the American College of Physicians and the 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. [PMID: 28135725]. doi:10.7326/M16-1785 LinkGoogle 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. [PMID: 28114673]. doi:10.7326/M16-1754 LinkGoogle Scholar3. Qaseem A, Forland F, Macbeth F, Ollenschläger G, Phillips S, van der Wees P; Board of Trustees of the Guidelines International Network. Guidelines International Network: toward international standards for clinical practice guidelines. Ann Intern Med. 2012;156:525-31. [PMID: 22473437]. doi:10.7326/0003-4819-156-7-201204030-00009 LinkGoogle Scholar4. Institute of Medicine. Clinical Practice Guidelines We Can Trust. Washington, DC: National Academies Pr; 2011. Google Scholar5. Ettehad D, Emdin CA, Kiran A, Anderson SG, Callender T, Emberson J, et al. Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis. Lancet. 2016;387:957-67. [PMID: 26724178] doi:10.1016/S0140-6736(15)01225-8 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Portland Evidence-based Synthesis Program and Portland VA Medical Center, Portland, Oregon; Minneapolis VA Center for Chronic Disease Outcomes Research and University of Minnesota School of Medicine, Minneapolis, Minnesota; American Academy of Family Physicians, Leawood, Kansas; and American College of Physicians, Philadelphia, Pennsylvania.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M16-1785. 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 Pharmacologic Treatment of Hypertension in Adults Aged 60 Years or Older Doreen M. Rabi , Stella S. Daskalopoulou , Alexander A. Leung , George Dresser , Raj Padwal , and Nadia Khan Pharmacologic Treatment of Hypertension in Adults Aged 60 Years or Older William C. Cushman , Karen C. Johnson , William B. Applegate , and Jeffrey A. Cutler Metrics Cited byMortality Outcomes With Intensive Blood Pressure Targets in Chronic Kidney Disease PatientsEffects of 12-week brisk walking training on exercise blood pressure in elderly patients with essential hypertension: a pilot study 15 August 2017Volume 167, Issue 4Page: 291-292KeywordsAcute myocardial infarctionBlood pressureDisclosureHeart failureHypertensionLongitudinal studiesPatientsPopulation statisticsSystematic reviewsTreatment guidelines ePublished: 15 August 2017 Issue Published: 15 August 2017 Copyright & PermissionsCopyright © 2017 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...