Lindsey Tanner, The Associated Press
Many older adults with high blood pressure (hypertension) can be treated less aggressively, which could mean taking fewer pills to get it under control, according to new treatment guidelines from an expert panel.
By: Don Penven
Many niches of good health information depend on a set of numbers that serve as a visual reference or reminder. Take Type 2 Diabetes… The A1c Test has been the guiding light for diabetics for decades. Just a few years back the threshold for type 2 diabetes was 70. But then medical science decided that 70 was too high and the new diabetes A1c number was reduced to 65.
What this meant was that millions of people who were being monitored as being pre-diabetic or borderline diabetic where quickly nudged into the realm of full-blown diabetics on medication. This meant even more billions of dollars pouring into the big pharmaceutical companies. What a coincidence!
But oddly enough, the reverse is now true for high blood pressure numbers. Members of this expert panel stress that they have not changed the definition of high blood pressure: 140 over 90. For adults aged 60 and older, they are just recommending a higher treatment threshold, and recommending prescribed medication only when blood pressure levels reach or exceed 150 over 90 or higher.
As may be expected, not all of medical science experts, as well as the U.S. Government agency that organized this panel, agrees with the panel’s decision. And it is a sure bet that Big Pharma is having a “Hissy-Fit” at these new, higher blood pressure numbers.
Panel members said that treating high blood pressure too aggressively often results in fainting, dizziness and falls in older patients, or, on occasion, bad interactions with drugs that seniors are already taking for other illnesses.
Also important to note is that the panel endorses the lower target of 140 over 90 for younger adults — and for all adults afflicted with diabetes or renal (kidney) disease.
Recently released guidelines are based on a review of the most rigorous kind of recently published medical research — studies in which patients are randomly prescribed drugs or dummy pills — available since the last update in 2003. This research points toward older patients avoiding major health problems like heart attacks, strokes and kidney disease even when their blood pressure is above the current recommended level.
Panel member, Dr. Paul James, states that for many patients, two or three drugs — or more — are needed to bring their blood pressure down. “Many older adults could probably reduce their doses, or take fewer drugs, to reach the new, less strict target,” he said. Dr. James is a panel member and family medicine specialist-researcher at the University of Iowa.
According to the Associated Press article, while the guidelines were updated by a government-appointed panel, they don’t have the government’s endorsement like previous versions. The panel completed its work earlier this year, around the same time that the National Heart, Lung and Blood Institute announced that it was getting out of the guidelines business and turning the job over to the American Heart Association and American College of Cardiology. Updated guidelines from those medical groups are expected in late 2014.
Whether many doctors will immediately alter their treatment options “remains to be seen,” said Dr. Curtis Rimmerman, a Cleveland Clinic cardiologist, who called the guidelines “exceedingly important” given the prevalence of high blood pressure, which affects about 1 in 3 U.S. adults, or 68 million.”
Rimmerman predicted that some will continue to push to get older patients’ blood pressure lower than the new recommendation, especially those with previous strokes or heart problems.
What does your health care provider have to say?