1. JNC8 Hypertension Guidelines, from 2014
2. ACP and AAFP Guideline for Treatment of Hypertension in Adults 60 Years Old and Older (Jan 2017)
Modification to the treatment cutoff of 150/90 for adults 60 or older to use the normal cutoff of 140/90 if the patient, 1) Has a history of stroke or TIA, or 2)
The guideline includes two additional recommendations:
“ACP and AAFP recommend that physicians consider initiating or intensifying drug therapy in adults aged 60 years old and older with a history of stroke or transient ischemic attack to achieve a target systolic blood pressure of less than 140 mm Hg to reduce the risk of recurrent stroke.
ACP and AAFP recommend that physicians consider initiating or intensifying pharmacological treatment in some adults aged 60 years old and older at high cardiovascular risk, based on individualized assessment, to achieve a target systolic blood pressure of less than 140 mm Hg to reduce the risk of stroke or cardiac events.
Increased cardiovascular risk includes all people with known vascular disease and among others, is defined as most patients with diabetes, individuals with chronic kidney disease with estimated glomerular filtration rate (eGFR) <45 mL/min/per 1.73 m2, metabolic syndrome (abdominal obesity, hypertension, diabetes, and dyslipidemia), and older age.” ACP and AAFP
3. 2017 ACC/AHA Hypertension Guidelines.
References
http://www.nmhs.net/documents/27JNC8HTNGuidelinesBookBooklet.pdf (Source of JNC8 Guidelines)
http://www.aafp.org/media-center/releases-statements/all/2017/ACP-AAFP-hypertension-guidelines.html