SOME JNC 8 PHYSCIANS COME OUT AGAINST LOOSENING BP THRESHOLDS FOR OLDER ADULTS

The Cleveland Plain Dealer (1/14, Townsend, 966K) reports that five physicians “who were part of the panel that issued updated treatment guidelines for high blood pressure last month” have written an article in the Annals of Internal Medicine in which they come “out against one of the recommendations saying that there is insufficient evidence to support it.” These “physicians – part of the 17-member panel Eighth Joint National Committee, or JNC 8 – are against raising the threshold at which older adults begin taking medication to control their blood pressure. The majority of the panel voted to raise the systolic blood pressure...from 140 to 150 for people age 60 and older who don’t have chronic kidney disease or diabetes.”

On its website, TIME (1/14, Sifferlin, 21.77M) reports that they wrote, “We, the panel minority, believed that evidence was insufficient to increase the [target systolic blood pressure] goal from its current level of less than 140 mm Hg because of concern that increasing the goal may cause harm by increasing the risk for CVD [cardiovascular disease] and partially undoing the remarkable progress in reducing cardiovascular mortality in Americans older than 60 years.”

CardioSource (1/14, 2K) reports, “The editorial does agree, however, with recommendations that SBP < 150 mmHg for frail individuals ≥ age 80 is a reasonable alternative approach to addressing concerns that elderly patients are at higher risk for treatment-related serious events.” Additionally, “the authors...add that ‘a target SBP less than 140 mmHg for patients less than 80 years would also be in line with guidelines from Europe, Canada, the ACCF/AHA, the United Kingdom, and the ASH/ISH.’”

MedPage Today (1/14, Neale, 122K) reports that while “the impact of the latest guidance – and the disagreement among the panel members – remains unclear...it is possible that clinicians will wait for hypertension recommendations from the American Heart Association and the American College of Cardiology, which are expected to be completed by early 2015.” Medscape (1/14, Wood, 164K) also covers the story.

Posted by:  Steven Almany M.D.