If you’re over 60 and your doctor is treating you for high blood pressure, your health status and patient history play a key role in that treatment.

In deciding on the upper limit for blood pressure, your doctor is striking a balance between the risk of stroke and the hazards of falls from dizziness that older adults may experience.

Experts are reaffirming the importance of assessing each patient individually in the wake of a recent easing of guidelines for the upper limit of blood pressure for older adults – and the controversy that followed the guideline adjustment.

A minority group within the Joint National Committee (JNC) that recently reviewed and made changes to blood pressure guidelines for physicians disagreed with one committee recommendation: raising target blood pressure for patients 60 years and older from 140/90 to 150/90. 

Balancing act

Minority opinion members on the JNC panel published their concerns in the April 2014 issue of the Annals of Internal Medicine. They say the recommended increase in blood pressure limits for those 60 years and older (absent diabetes or kidney disease) is unwise.

The JNC panel based the disputed recommendation, in part, on review of two large studies of older patients, many who were 70-plus years of age. The panel focused on the issue of balance and falls.

. “Looking at whether tight control below 140 was more beneficial, it turned out that the older you got, having lower and lower blood pressure was associated with dizziness and falling, which is a very, very serious complication in the elderly

We know that high blood pressure – hypertension — is the most important modifiable risk factor for stroke. It’s responsible for 30 percent of strokes. And now this study suggests that even a slight elevation in blood pressure is significant.”