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Q: What is considered normal blood pressure for a person 70 years of age or older? My doctor told me that this should be around 120/80. But I read that the pressure of the elderly could be stronger – closer to 140/90 – and that this pressure would not be dangerous. Am I the only one to be confused by the new blood pressure guidelines?
A: No, you're not the only one who has trouble understanding the new blood pressure guidelines.
They were published in November 2017 and we have since received letters about this. The questions are not limited to the lay public, either. Due to several issues, which we will discuss in a moment, these stricter guidelines are also an ongoing topic of discussion among health care providers.
But let's start with your main question.
You're correct that in the past, blood pressure targets for seniors were more vague. They allowed a normal blood pressure range slightly higher than that of younger adults. However, the most recent directives do not provide the same benefits.
As your doctor explained, the American College of Cardiology and the American Heart Association now define normal blood pressure in adults as a value less than 120/80. If the higher number is between 120 and 129, even with a number less than 80 or less, this is considered high blood pressure. Readings of 130/80 and above are the threshold for several increasing stages of hypertension.
For now, these guidelines apply to all healthy adults, regardless of age.
According to some estimates, the new guidelines have allowed almost half of adults to switch to the category of hypertension, essentially overnight.
Part of the thinking behind the update was that reporting potential hypertension early would encourage patients and their physicians to discuss appropriate lifestyle changes.
However, the rigor of the new objectives has provoked many discussions and even discord.
The updated guidelines are based on the results of a study known as the Interventional Test for Systolic Blood Pressure or SPRINT. As part of the study, participants rested quietly for five minutes before reading their blood pressure, performed using an automated device. Three consecutive readings were then averaged together to arrive at a final number.
This is quite different from the way blood pressure is usually measured in a doctor's office as many health professionals have argued that the methodology had a statistically significant impact on the results.
In addition, they answer your question by saying that it is unreasonable to expect that someone in the last year will have the same blood pressure as someone in their thirties.
None of this changes the fact that hypertension is dangerous.
Uncontrolled blood pressure increases the risk of serious health problems, such as blood clots, strokes, kidney disease, heart disease and heart attacks.
In addition, the higher the numbers, the higher the risks.
We advise you to discuss it with your primary care doctor, who knows your general health, your medical history and any specific risks you are facing. It will help you define the blood pressure goals that are right for you.
• Eve Glazier, M.D., MBA, is an internist and associate professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and assistant professor of medicine at UCLA Health. Send your questions to [email protected].
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