CHICAGO — Many older adults with high blood pressure can be treated less aggressively, which could mean taking fewer pills to get it under control, according to new treatment guidelines from an expert panel. But not all experts are on board with the advice – including the federal agency that appointed the group.

Panel members stressed that they are not changing the definition of high blood pressure: 140 over 90. For adults aged 60 and older, they are recommending a higher treatment threshold, prescribing medicine only when blood pressure levels reach 150 over 90 or higher.

Too aggressive blood pressure treatment can cause fainting and falls in older patients, or bad interactions with drugs they’re already taking for other illnesses, panel members said. The panel does endorse the lower target of 140 over 90 for younger adults – and for all adults who also have diabetes or kidney disease.

The guidelines released Wednesday are based on a review of the most rigorous kind of medical research – studies in which patients are randomly prescribed drugs or dummy pills – published since the last update in 2003. The research suggests older patients can avoid major health problems even when their blood pressure is above the current recommended level.


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