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Updated blood pressure guidelines leave some seniors confused

Q: What is a normal blood pressure for a person considered in the late 70's? My doctor said it should…

Q: What is a normal blood pressure for a person considered in the late 70’s? My doctor said it should be in the 120/80 range. But I have read that elderly depression may be higher – closer to 140/90 – and the pressure would not be dangerous. Am I the only one who is confused by the new blood pressure guidelines?

A: No, you’re not alone in struggling to understand the revised blood pressure guidelines.

They were issued in November 2017 and we have received emails about them since then. The questions are also not limited to the laymen. Due to several issues that we will address in a moment, these stricter guidelines are also an ongoing discussion paper between healthcare providers.

But let’s start with your main question.

You are correct that in the past, the blood pressure targets for older adults were looser. They allowed a slightly higher range of normal blood pressure compared with younger adults. However, the new guidelines do not make the same remuneration.

As your doctor explained, the American College of Cardiology and the American Heart Association now usually define blood pressure for adults as readings less than 120/80. If the peak count falls between 120 and 129, even with a lower number of 80 or less, this is considered to be elevated blood pressure. Readings of 130/80 and higher are the threshold of several escalating stages of high blood pressure.

At this time, these guidelines apply to all healthy adults, regardless of age.

According to some estimates, they have updated the guidelines

Part of the idea behind the update was to flag potential hypertension earlier to encourage patients and their doctors to discuss appropriate lifestyle changes.

But the severity of the new goals has caused a lot of discussion, and even discord.

The updated guidelines are based on results from a study called Systolic Blood Pressure Intervention Trial, or SPRINT. In the study, participants quietly rested for five minutes before their blood pressure measurements, which were taken with an automatic device. Three consecutive readings are then taken together to arrive at a final number.

This differs from how the blood pressure is typically measured at a surgery that many healthcare professionals have argued that the method had a statistically significant impact on the outcome.

In addition, they raise your question and say it’s unreasonable to expect someone in their recent years to have the same blood pressure as someone in their 30’s.

None of this changes the fact that high blood pressure is dangerous.

Uncontrolled blood pressure increases the risk of digestive health problems, including blood clots, stroke, kidney disease, heart disease and myocardial infarction.

Not only that, the higher the numbers the higher the risks are the risks.

Our advice is to discuss the issue with your primary care staff who are familiar with your general health, medical history and any specific risks you face. He or she will help you set the blood pressure goals that suits you.

• Eva Glazier, M.D., MBA, is an intern and professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an intern and assistant professor of medicine at UCLA Health. Send your questions to [email protected]

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