NEW RECOMMENDATIONS ON HYPERTENSION MANAGEMENT IN OLDER PEOPLE RELEASED

The New York Times (12/19, A23, Kolata, Subscription Publication, 9.61M) reports that “new guidelines suggest that people over 60 can have a higher blood pressure than previously recommended before starting treatment to lower it.” The guidelines committee, “composed of 17 academics, was tasked with updating guidelines last re-examined a decade ago.” The recommendations were “published online on Wednesday in The Journal of the American Medical Association.”

The AP (12/19) reports that “the panel completed its work earlier this year, around the same time that the National Heart, Lung and Blood Institute announced that it was getting out of the guidelines business and turning the job over to the American Heart Association and American College of Cardiology.” NHLBI Director Dr. Gary Gibbons released “a statement Wednesday emphasizing that his agency has not sanctioned the panel’s report, nor has the broader National Institutes of Health.” Although he pointed out “that the panel decided not to collaborate with the heart groups’ efforts, Gibbons said his agency would work with those groups ‘to transition’ the panel’s evidence review into their update.”

       

The Wall Street Journal (12/19, A2, Winslow, Subscription Publication, 5.91M) points out that neither the American College of Cardiology nor the American Heart Association vetted the document, nor did the NHLBI. This led one NHLBI researcher to remove his name from the document, according to Michael Lauer, director of cardiovascular sciences at NHLBI

       

The Los Angeles Times (12/19, Kaplan, 3.07M) “Science Times” blog reports that “rather than aim for a target blood pressure of 140/90 mm Hg, the target will be relaxed slightly to 150/90 mm Hg, according to” the “new guidelines.” The guidelines’ authors “emphasized that they were not changing the definition of high blood pressure.” Instead, “they are recognizing that data from randomized clinical trials do not show that using drugs to nudge down systolic blood pressure from 150 to 140 provides any health benefit.”

       

Bloomberg News (12/19, Cortez, 1.91M) reports that individuals aged “60 and older were focused on in the guidelines because they ‘are a unique population and we are concerned about the number of medications that may be required,’ said Paul James, the lead author of the article.”

       

Forbes (12/19, Husten, 6.03M) contributor Larry Husten writes that “one important difference between the hypertension guideline and the AHA/ACC guidelines released last month is the approach to risk assessment.” While “the AHA/ACC recommendations were based on an assessment of total cardiovascular risk, the hypertension guideline is more narrowly focused on blood pressure.”

       

According to the Boston Globe (12/19, Kotz, 1.75M), “a number of cardiologists...complained that the new guideline was not issued by any major medical group or government entity.”

       

Harlan Krumholz, MD, discusses the guidelines in the New York Times (12/19, 9.61M) “Well” blog.

       

CardioSource (12/19, 2K) reports, “Practice guidelines are traditionally promulgated by the government or by learned medical professional societies. The JAMA paper is a report of a group experts in the field of hypertension, but it does not carry the endorsement of any organized body. Moving forward, these recommendations will be taken into account in the coming year as the ACC/AHA Task Force on Practice Guidelines moves forward with developing the collaborative model to update the national hypertension guidelines in partnership with the National Heart, Lung, and Blood Institute (NHLBI).” Also covering the story are CNN (12/19, Willingham, 14.53M), MedPage Today (12/19, Neale, 122K), and HealthDay (12/19, Thompson, 5K).

Posted by:  Steven Almany M.D.