For patients over age 60 with hypertension, which BP target is typically advised?

In managing hypertension for patients over age 60, current guidelines typically recommend a blood pressure target of 150/90 mmHg. This target is based on evidence suggesting that achieving a systolic blood pressure below 150 mmHg can significantly reduce the risk of cardiovascular events and complications related to hypertension while minimizing the risk of adverse effects associated with more aggressive blood pressure lowering.

For this age group, the risk-to-benefit ratio of lowering blood pressure too much can shift, as older adults may have variances in physiology and potential comorbidities. The target of 150/90 mmHg balances the management of hypertension while considering the patient's overall health and the potential side effects that may arise from more stringent targets.

In contrast, targets like 130/80 mmHg or lower may be more appropriate for younger patients or those at high risk of cardiovascular disease but could increase the likelihood of complications, such as falls or acute kidney injury, in older patients, particularly those with frailty or multiple medications. The goal is to achieve a practical level of control without introducing unnecessary harm, which is why the 150/90 mmHg recommendation stands out as a commonly accepted guideline in this demographic.