Benefits and Harms of Treating Blood Pressure in Older Adults: A Systematic Review and Meta-analysis [Internet]

Review
Washington (DC): Department of Veterans Affairs (US); 2016 Apr.

Excerpt

Hypertension is a very common chronic illness in the United States and among Veterans. Use of antihypertensive medications can lower the risk of cardiovascular disease, cerebrovascular disease, renal disease, and death. The most beneficial blood pressure targets for patients of specific age groups, however, has been a topic of some debate and controversy, stemming from concerns that the ratio of benefit to harm of a given blood pressure level may vary with age. In 2014, the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (previously JNC-FG8, referred to in this report as JNC-BP) published new guidelines for the treatment of hypertension, as well as a new treatment goal for older individuals (over age 60) for systolic blood pressure (SBP) of < 150 mm Hg rather than < 140 mm Hg. The new goal for those over 60 years of age has been very controversial; the issue of the appropriate (safest and most beneficial) goal for older people has been debated among experts with viewpoints supporting both higher and lower treatment goals. The objectives of this review are to examine the benefits and harms of differing blood pressure targets among adults over age 60.

Publication types

  • Review

Grants and funding

Prepared for: Department of Veterans Affairs, Veterans Health Administration, Quality Enhancement Research Initiative, Health Services Research & Development Service, Washington, DC 20420. Prepared by: Evidence-based Synthesis Program (ESP), Portland VA Health Care System, Portland, OR, Devan Kansagara, MD, MCR, Director