As word gets out about the controversial blood pressure guideline changes published by the Eighth Joint National Committee (JNC 8), the big question for clinicians is “what impact does this have on how we treat patients?” Fortunately, Duke University researchers are looking into this for you. An April 2014 JAMA analysis states that almost 6 million Americans currently taking BP medications might be able to throw them away based on new guidelines and another 13.5 million previously-diagnosed patients with uncontrolled hypertension now meet healthy blood pressure benchmarks.
According to Dr. Ann Marie Navar-Boggan, Cardiology Fellow at Duke University and lead author for the study, “Our findings show that there are a lot of adults who fall into the gray area (a systolic pressure between 140 and 150) – an area for which there is no consensus.” This leaves physicians in a gray area as well – considering whether or not to treat patients older than 60 who fall within these parameters. There is evidence on both sides of the table and it does not seem like there is a majority on either side. In fact, several JNC 8 panel members published a post-guidance statement indicating their disagreement with some of the published BP guidelines. With this lack of consensus, it’s quite possible clinicians will have to “pick a side” based on their own research or simply take each patient on a case-by-case basis.
Dr. Navar-Boggan also suggests that older adults would still need to monitor their blood pressure and should be encouraged to make lifestyle modifications such as getting more exercise and reducing sodium intake. Sounds like good advice for everyone – not just our aging population! Regardless of the difference of opinions regarding the guidelines, experts do agree that hypertension is a major public health threat that must continue to be addressed.