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Commentary on: Weiss J, Freeman M, Low A, et al. Benefits and harms of intensive blood pressure treatment in adults aged 60 years or older: a systematic review and meta-analysis. Ann Intern Med 2017;166:419–429.
There has been debate around blood pressure (BP)-lowering targets for older people, with concerns about adverse effects (AEs) such as falls and cognitive changes. The 2014 Eighth Joint National Committee (JNC8) guidelines suggested a less intensive systolic BP (SBP) target of <150 mm Hg for people aged ≥60 years,1 while the 2017 American College of Cardiology/American Heart Association (ACC/ AHA) guidelines recommend target SBP of <130 mm Hg for community-dwelling ambulant adults aged ≥65 years with an average SBP of >130 mm Hg, the same target as those <65 years with high-risk or established cardiovascular disease.2 This change is, in part, because of the strongly positive results seen in elderly participants in the Systolic Blood Pressure Intervention Trial (SPRINT). …
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