There is a lot of confusion regarding when to start blood pressure medication. I will try to explain it very simply so that you don’t have a headache! The latest recommendations for blood pressure management are found in the JNC 8 guidelines. Essentially a lot of the information is obtained and adapted from European studies. The quick and simple is outlined below:
- Patients <60 years of age: start pharmacotherapy at 140/90 mmHg.
- Patients with diabetes: start pharmacotherapy at 140/90 mmHg.
- Patients with CKD(chronic kidney disease) : start pharmacotherapy at 140/90 mmHg
- Patients 60 years of age and older: start pharmacotherapy at 150/90 mmHg.
If your primary care doctor is prescribing medications and your not falling into these four categories, you need to talk to your PCP regarding your regimen. In the hospital I encounter a number of patient that say they have hypertension. When asked what there blood pressure is off medications they say I’m in the 140s. When I look at there chart they are older than 60. Based on the new definition, and excluding diabetes, CKD they do not meet the guidelines and I end up stopping their medications. The reason physicians are raising the blood pressure cut off is to prevent the elderly population from being harmed. Harms include side effects of medications, lower blood pressures, and fall reduction to name a few.
-Know your meds, DR SARELA.
sarelamedical.com 