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Thousands of adults may be needlessly taking tablets
for high blood pressure, doctors say. A panel of experts in the U.S. has
recommended that adults over 60 should only be prescribed medicine when
their blood pressure levels reach 150 over 90 or higher.
This is due to the side effects that blood pressure tablets can cause,
such as fainting and falls in older people and interaction with other
medicines they are taking.
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The new guidance was published in the Journal of the American Medical
Association.
In it, the doctors stress they are not changing the definition of high
blood pressure: 140/90.
And people with heart disease, diabetes or chronic kidney disease should
aim for a reading of 130/80 or lower.
But they do recommend that adults aged 60 and older are given a higher
treatment threshold - and only take medicine when their blood pressure
levels reach 150 over 90 or higher.
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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.
However much of the existing guidance does remain - such as giving
younger adults with a reading of 140/90 medication and also those with
diabetes or kidney disease.
A third of people in the UK and U.S. have high blood pressure - and a
third do not realise. It is a major risk factor for heart disease,
stroke, and kidney failure.
A high blood pressure reading is one that exceeds 140/90 millimetres of
mercury (mm Hg).
The first figure, the systolic pressure, corresponds to the ‘surge’ that
occurs with each heart beat.
The condition typically has no symptoms, so it goes undetected or
untreated in many people.
In developed countries like the UK, the lifetime risk of developing high
blood pressure is now 90 per cent and six million Britons take drugs to
control it - usually for life.
People with hypertension - the medical term - are routinely advised to
change their lifestyle and eat less salt, lose weight, drink less
alcohol, eat more fruit and vegetables and exercise more.
The new guidelines were based on a review of the most rigorous kind of
medical research - studies in which patients are randomly prescribed
drugs or dummy pills - published since the last update in 2003.
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The research suggests older patients can avoid major health problems
like heart attacks, strokes and kidney disease even when their blood
pressure is above the current recommended level, the panel said.
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.
While the guidelines were updated by a government-appointed panel, they
don't yet have the government's endorsement like previous versions.
And some doctors fear the experts didn't take into account the effects
of under treating high blood pressure in older people.
Dr. Curtis Rimmerman, a Cleveland Clinic cardiologist, called the
guidelines 'exceedingly important' given the prevalence of high blood
pressure.
The panel added that the guidelines are simply recommendations, and that
doctors should make treatment decisions based on patients' individual
circumstances. |