Blood Pressure words on a thermometer measuring your hypertension, with level rising past normal, elevated and danger to burst at maximum point

Blood Pressure: How Low Should You Go?

High blood pressure affects a third of adults in America, and only half of them have it under control. Adults over 60 have double the rate of hypertension as the general population. Finding the right blood pressure for you may not be straightforward.

The American College of Physicians and the American Academy of Family Physicians have released new guidelines for finding a target blood pressure for adults over 60. The new guidelines state that patients with a history of stroke or heart attack should target 140 systolic blood pressure. This is the lower end of what is considered high blood pressure. If the pressure lands between 140 and 150, they may not need to be treated. Aiming below 140 may reduce risk of stroke and other cardiac problems, but it does not change the overall death rate or improve their quality of life.

Blood pressure may go up as a result of stress, diet, and other medical conditions. Increasing medication increases risks of fainting and decreased kidney function, but not risks of falls and dementia. Exercise and lowering salt intake also help control chronic hypertension.

A study in 2015 found that lower blood pressure was better (although the trial was stopped early), leading physicians to treat hypertension more aggressively with more medication. Going too low can risk other side effects. It is important to have a relationship with a primary care doctor who can help decide what is best for the patient.

The American Heart Association is firm about taking action when blood pressure hits 140. There may be a benefit to targeting lower numbers, but they will be looking at every study that has come out since the last AHA recommendation. More research is needed to understand and personalize patient treatment for high blood pressure. 80 million hypertensive people in the U.S. have different health needs and goals.
Nedelman, Michael. “Controversial new blood pressure guidelines aren’t one-size-fits-all.” Health. 19 Jan 2017. Web. 22 Jan 2017.

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