For years physicians have struggled to identify the optimal blood pressure for a given patient population. The group of experts collectively known as the JNC (Joint National Commission) has been historically tasked to address the use of antihypertensive agents. Every few years, the JNC publishes recommendations on various topics as they relate to hypertension. Their conclusions are derived from a rigorous review of the scientific literature.
It is important to note, that low blood pressure may be detrimental as well. As the body ages, the arteries stiffen, and physiologically an increase in blood pressure is necessary to ensure proper organ perfusion. Numerous publications attest to this. Cox et al concluded that “lowering blood pressure to the lower part of normal could be harmful to elderly patients [1].” In essence, a careful balance is what is needed. The latest edition of the evidencebased guidelines, JNC 8, attempts to reconcile this endeavour.
From a practical management perspective, this approach simplifies matters significantly. In essence, for patients 60 years old or greater, a reasonable target is 150/90. For patients less than age 60, a goal of 140/90 is desirable, With regard to diabetics or patients with chronic renal disease, the recommended value is also 140/90 [2]. One must remember that these are guidelines, and ultimately the treating physician makes a decision based upon other clinical factors.
- J. Hypertens Suppl. 1992 Apr? 10(2):S1723.
- JAMA. 2014? 311(5):507520