23 January 2018
Hypertension Limbo: Balancing Benefits, Harms, and Patient Preferences Before We Lower the Bar on Blood Pressure
The recent hypertension guideline from the American College of Cardiology (ACC), the American Heart Association (AHA), and partner organizations—a synopsis of which is in this issue (1)—raises important questions about hypertension diagnosis and treatment. The guideline differs substantially from those of other organizations, including the American College of Physicians (ACP) and the American Academy of Family Physicians (AAFP) (2). Here, we examine these differences, focusing on pharmacologic treatment of adults older than 60 years. Strengths of the ACC/AHA guideline include its emphasis on the importance of blood pressure (BP) measurement technique and lifestyle changes. However, the guideline falls short in weighing the potential benefits against potential harms, costs, and anticipated variation in individual patient preferences.
READ MORE …