Managing High Blood Pressure in Octogenarians

iStock_000012753279_FullCould one benefit of aging be taking fewer medications?  That outrageous idea may be the upshot of a study Rick and I discuss on PodMed this week, as published in JAMA, taking a look at appropriate management of high blood pressure in those aged 80 and older. The study aggregated six post hoc analyses of data from the Hypertension in the Very Elderly Trial, conducted in almost 4000 hypertensive subjects over the age of 80. The analysis concludes that for older folks who are generally healthy and functional, high blood pressure should be managed according to the guidelines for those older than 65, with positive impact on outcome measures such as total mortality and cardiovascular events.  A target systolic blood pressure of 140-150 should be employed, and one or two medications at most, relieving many of the burden of polypharmacy, or at least reducing it. For those who are frail, and already taking a multitude of medications for other conditions, hypertension management should be conservative at best, with that catch all phrase 'individualized treatment' used.

No doubt for many older folks, this relaxation of blood pressure targets will come as a relief, and underscores observations we've made before: as we age our physiology changes, and reasonable accommodation should be made.  Other topics this week include the cost and effectiveness of cholesterol guidelines and a new drug for high potassium, also in JAMA, and in NEJM, a snapshot of community acquired pneumonia.  Until next week, y'all live well.

VN:F [1.9.17_1161]
Rating: 0.0/5 (0 votes cast)
No Comments

Leave a Comment

You can use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <s> <strike> <strong>

Johns Hopkins Medicine does not necessarily endorse, nor does Johns Hopkins Medicine edit or control, the content of posted comments by third parties on this website. However, Johns Hopkins Medicine reserves the right to remove any such postings that come to the attention of Johns Hopkins Medicine which are deemed to contain objectionable or inappropriate content.

Previous post:

Next post: