What do you think of lowering the definition of hypertension?

[futureapppsy2]

Did changing the cut-off from 140/90 to 130/80 in 2017 change your clinical decisions? Do you think it's justified by the evidence?

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[VA Hopeful Dr]

Did changing the cut-off from 140/90 to 130/80 in 2017 change your clinical decisions? Do you think it's justified by the evidence?

Nope. I'm not giving BP meds (or sticking them with a hypertension diagnosis for life) to someone whose BP is 131/81.

Technically it is evidenced based if you look at the BP v. mortality curve, but most HTN literature ignores how often shooting for perfect causes symptomatic hypotension.

 

[Ironheme]

Did changing the cut-off from 140/90 to 130/80 in 2017 change your clinical decisions? Do you think it's justified by the evidence?

It changed it slightly. For my younger patients, I'm more strict about the BP (ACC guidelines) and explain to them why. For my older patients, I stick with JNC 8 because I've noticed what VA hopeful Dr mentioned - the symptomatic hypotension. I hate having to bring them back in for constant rechecks and readjusting. Also, they didn't include family docs in that discussion of <130/80 mmHg...