From the Guidelines
The JNC 8 blood pressure goal for a 68-year-old patient with no comorbidities is less than 150/90 mmHg. This recommendation is based on the guidelines outlined by the Joint National Committee 8, which aimed to simplify treatment goals and make them easier to apply to patient care 1. According to the JNC 8 guidelines, the blood pressure treatment goal for patients aged 60 years or older without chronic kidney disease (CKD) or diabetes is less than 150/90 mmHg.
Key points to consider in managing hypertension in this patient population include:
- The JNC 8 guidelines recommend a more relaxed blood pressure target for older adults compared to previous guidelines, recognizing the potential risks of overly aggressive blood pressure lowering in this population 1.
- Lifestyle modifications, such as sodium restriction, weight loss if overweight, regular physical activity, and moderation of alcohol consumption, should be initiated first if the patient's blood pressure exceeds the target.
- If lifestyle modifications are insufficient, pharmacological therapy should be considered, typically starting with thiazide diuretics, calcium channel blockers, ACE inhibitors, or ARBs as first-line agents 1.
- Regular monitoring of blood pressure and kidney function is important when initiating or adjusting antihypertensive medications in older adults.
It is essential to note that these guidelines should be viewed as minimal standards for most patients, and treatment decisions should be individualized based on the patient's specific needs and health status 1.
From the Research
JNC 8 Blood Pressure Goals
- The JNC 8 guidelines recommend a blood pressure goal of less than 150/90 mmHg for adults aged 60 years and older without diabetes mellitus or chronic kidney disease 2.
- For adults aged 60 years and older with diabetes mellitus or chronic kidney disease, the recommended blood pressure goal is less than 140/90 mmHg 3.
- It is worth noting that some studies disagree with the higher systolic blood pressure goal recommended by JNC 8 guidelines for adults aged 60 years and older without diabetes mellitus or chronic kidney disease, citing concerns that it may lead to an increase in cardiovascular events and mortality 3.
Application to a 68-year-old with no Comorbidities
- Based on the JNC 8 guidelines, a 68-year-old patient with no comorbidities would have a recommended blood pressure goal of less than 150/90 mmHg 2.
- This goal is specific to adults aged 60 years and older without diabetes mellitus or chronic kidney disease, making it applicable to this patient's demographic 3, 2.