From the Guidelines
The American Academy of Family Physicians (AAFP) defines hypertension as a systolic blood pressure of 150 mm Hg or higher in adults aged 60 years or older, as stated in the 2017 joint guideline with the American College of Physicians 1. This definition is based on the strong recommendation to initiate treatment in adults aged 60 years or older with systolic blood pressure persistently at or above 150 mm Hg to achieve a target systolic blood pressure of less than 150 mm Hg, in order to reduce the risk for mortality, stroke, and cardiac events. Key points to consider when defining hypertension according to the AAFP include:
- Accurate measurement of blood pressure is important before initiating treatment for hypertension
- Some patients may have elevated blood pressure in clinical settings, and ambulatory measurement may be appropriate
- Clinicians should consider treatment with nonpharmacologic options, including weight loss, dietary changes, and an increase in physical activity, initially or concurrently with pharmacologic treatment The AAFP's definition of hypertension is focused on adults aged 60 years or older, and recommends that clinicians select treatment goals based on a periodic discussion of the benefits and harms of specific blood pressure targets with the patient 1. It's worth noting that the AAFP also recommends considering initiating or intensifying pharmacologic treatment in adults aged 60 years or older with a history of stroke or transient ischemic attack to achieve a target systolic blood pressure of less than 140 mm Hg, as well as in some adults aged 60 years or older at high cardiovascular risk, based on individualized assessment 1.
From the Research
Definition of Hypertension
The American Academy of Family Physicians (AAFP) definition of hypertension is not explicitly stated in the provided studies. However, according to the study 2, the 2017 American College of Cardiology/American Heart Association (ACC/AHA) guideline defines hypertension as a blood pressure of 130/80 mmHg or higher.
Blood Pressure Thresholds
The studies provide information on different blood pressure thresholds, including:
- 130/80 mmHg or higher, as defined by the 2017 ACC/AHA guideline 2
- 140/90 mmHg or higher, as mentioned in the study 3
- 120-139/80-89 mmHg, which is considered prehypertension 4
AAFP Stance on Hypertension Guidelines
The AAFP has decided not to endorse the 2017 ACC/AHA hypertension guideline, citing flaws in the guideline development process and limited additional benefit for lower treatment targets 2.
Key Points
- The AAFP definition of hypertension is not explicitly stated in the provided studies.
- The 2017 ACC/AHA guideline defines hypertension as a blood pressure of 130/80 mmHg or higher 2.
- Different blood pressure thresholds are mentioned in the studies, including 140/90 mmHg or higher and 120-139/80-89 mmHg 3, 4.