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Higher blood pressure OK in older adults

Published: Thursday, Dec. 19, 2013 11:30 a.m. CST

CHICAGO (AP) — Many older adults with high blood pressure 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. But not all experts are on board with the advice — including the federal agency that appointed the group.

Panel members stressed that they are not changing the definition of high blood pressure: 140 over 90. For adults aged 60 and older, they are recommending a higher treatment threshold, prescribing medicine only when blood pressure levels reach 150 over 90 or higher.

Too aggressive blood pressure treatment can cause fainting and falls in older patients, or bad interactions with drugs they’re already taking for other illnesses, panel members said.

The panel does endorse the lower target of 140 over 90 for younger adults — and for all adults who also have diabetes or kidney disease.

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, said Dr. Paul James, a panel member and family medicine specialist-researcher at the University of Iowa.

James said panel members chose to release their guidelines independently to get the recommendations out sooner and into the hands of primary care doctors, who treat large numbers of patients with high blood pressure. The guidelines were published online Wednesday in the Journal of the American Medical Association.

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