New Blood Pressure Guidelines

Strong debate is still on-going over the newest blood pressure guidelines recommended by a panel of experts last week. The Boston Globe‘s Deborah Kotz summarizes the findings nicely, and boils them down to five major points:

1. The threshold for treating high blood pressure has been raised for older Americans.

2. Drugs should no longer be used in older Americans to drive down their systolic pressure to below 150.

3. Adults under age 60 should aim to have their blood pressure below 140/90.

4. Lifestyle changes to lower blood pressure should be emphasized along with medications.

5. Expanded array of drugs recommended as a first line of treatment.

The American Heart Association, and others, have approached the new recommendations with some hesitance. There is a genuine concern for the unintended consequence of telling people they can let their blood pressure go up more without taking medication. The debate is a good one, and one that we should be having. Most importantly, it reminds us that health care is ultimately about getting the diagnosis and treatment right. That won’t always be a black or white issue, but it is one that requires regular review of the way things have always been done. Just because blood pressure guidelines have always been X, and medication has always been prescribed at X, does not mean that practice must continue, especially if the evidence shows otherwise.

If these new recommendations do take hold, there is the potential to reduce the effects of unnecessary medication while reducing huge amounts of wasted health care spending. However, because it forces us to get it right, the conversation is still the most important part.



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