Pharmacologic Treatment of Hypertension in Adults Aged 60 Years or Older
Authors: Doreen M. Rabi, Stella S. Daskalopoulou, Alexander A. Leung, George Dresser, Raj Padwal, Nadia Khan
Journal: Annals of Internal Medicine (2017)

Letters15 August 2017Pharmacologic Treatment of Hypertension in Adults Aged 60 Years or OlderDoreen M. Rabi, MS, MSc, Stella S. Daskalopoulou, MD, MSc, PhD, DIC, Alexander A. Leung, MD, MPH, George Dresser, MD, PhD, Raj Padwal, MD, MSc, and Nadia Khan, MD, MScDoreen M. Rabi, MS, MScFrom Hypertension Canada, Markham, Ontario, Canada.Search for more papers by this author, Stella S. Daskalopoulou, MD, MSc, PhD, DICFrom Hypertension Canada, Markham, Ontario, Canada.Search for more papers by this author, Alexander A. Leung, MD, MPHFrom Hypertension Canada, Markham, Ontario, Canada.Search for more papers by this author, George Dresser, MD, PhDFrom Hypertension Canada, Markham, Ontario, Canada.Search for more papers by this author, Raj Padwal, MD, MScFrom Hypertension Canada, Markham, Ontario, Canada.Search for more papers by this author, and Nadia Khan, MD, MScFrom Hypertension Canada, Markham, Ontario, Canada.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L17-0285 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:As contributors to Hypertension Canada's clinical practice guidelines, we have concerns about Qaseem and colleagues' new recommendations on hypertension management in persons aged 60 years or older, which were developed by the American College of Physicians and the American Academy of Family Physicians (1). These recommendations were based on a systematic review by Weiss and associates, which evaluated the effect of more versus less intensive lowering of systolic blood pressure (SBP) on cardiovascular outcomes in this population and was published in the same issue. Weiss and colleagues' review, while well done, had notable limitations. Namely, data were ...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. 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 Scholar3. Xie X, Atkins E, Lv J, Bennett A, Neal B, Ninomiya T, et al. Effects of intensive blood pressure lowering on cardiovascular and renal outcomes: updated systematic review and meta-analysis. Lancet. 2016;387:435-43. [PMID: 26559744] doi:10.1016/S0140-6736(15)00805-3 CrossrefMedlineGoogle Scholar4. 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 Scholar5. Williamson JD, Supiano MA, Applegate WB, Berlowitz DR, Campbell RC, Chertow GM, et al; SPRINT Research Group. Intensive vs standard blood pressure control and cardiovascular disease outcomes in adults aged > =75 years: a randomized clinical trial. JAMA. 2016;315:2673-82. [PMID: 27195814] doi:10.1001/jama.2016.7050 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Hypertension Canada, Markham, Ontario, Canada.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L17-0285. 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 Devan Kansagara , Timothy J. Wilt , Jennifer Frost , and Amir Qaseem 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 15 August 2017Volume 167, Issue 4Page: 289-290KeywordsBlood pressureDisclosureElderlyHypertensionMortalitySerious adverse eventsStrokeSystematic reviewsSystolic pressureTreatment guidelines ePublished: 15 August 2017 Issue Published: 15 August 2017 Copyright & PermissionsCopyright © 2017 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...