New blood pressure guidelines for U.S. adults age 60 and older are higher -- 150/90 -- but for those age 60 and younger they remain at 140/90.
Dr. Paul A. James, chairman of the department of family medicine at the University of Iowa and co-chairman of the guidelines committee, told the New York Times, "If you get patients' blood pressure below 150, I believe you are doing as well as can be done based on scientific evidence."
For example, two Japanese studies in seniors found those who reduced their systolic pressure to less than 140 fared no better than those who dropped it to between 140 and 160, or between 140 and 149, The Times said.
The guidelines committee of 17 academics spent five years conducting a rigorous review of the evidence and the higher numbers challenge the blood pressure guidelines in effect for the last 30 years.
Dr. William White, president of the American Society of Hypertension, said millions might not need to take medication to reach the new guideline of 150/90.
Dr. Marvin Moser, a hypertension expert, who was chairman of the first blood pressure guidelines committee in 1977 and six similar committees after, but not this the most recent one committee said the old guideline had "spectacular," success, with the incidence of strokes down by 70 percent since 1972, and heart failure rates have reduced by 50 percent. Hypertension is inexpensive to treat because 90 percent of blood pressure drugs are now generics, Moser said.
Why mess with something that works? Moser asked.
However, James said the blood pressure drugs have risks and medications that lower blood pressure can have side effects that counteract some of their benefits. Some seniors have to take several medications for other chronic diseases and the medications could interact.
In addition, James pointed out that some medicated seniors might end up with blood pressure so low when they stand they get dizzy. A woman who gets dizzy when she gets up, falls and breaks her hip is a terrible thing, James said.
Dr. George Bakris, director of the hypertension center at the University of Chicago, said the committee proposed guidelines and for many older patients, whether the benefits of hypertension medication outweighs the risk, is a judgment call for individual doctors and their patients.
The guidelines were published in The Journal of the American Medical Association.