From the Guidelines
For a 69-year-old healthy woman with no cardiovascular disease risk factors, the recommended approach is to maintain a blood pressure of less than 120/70 mmHg through lifestyle measures for prevention, as she is considered to have non-elevated blood pressure. This recommendation is based on the most recent guidelines from the European Heart Journal, specifically the 2024 ESC guidelines for the management of elevated blood pressure and hypertension 1. According to these guidelines, individuals with non-elevated blood pressure should focus on lifestyle measures to prevent the development of elevated blood pressure or hypertension.
Key lifestyle modifications include:
- Regular physical activity, aiming for at least 150 minutes of moderate-intensity exercise weekly
- Maintaining a healthy weight
- Following a DASH diet rich in fruits, vegetables, whole grains, and low-fat dairy with reduced sodium
- Limiting alcohol consumption to one drink or less daily
- Reducing sodium intake to less than 2,300 mg per day
These lifestyle changes are recommended as the first line of approach for individuals with non-elevated blood pressure, as they can help maintain optimal blood pressure levels and reduce the risk of developing cardiovascular disease. The guidelines emphasize the importance of individual clinical judgment and shared decision-making when considering blood pressure-lowering treatment, especially in certain subgroups such as older adults or those with specific health conditions 1.
In the context of this patient, who is a healthy 69-year-old woman with no cardiovascular disease risk factors, the focus should remain on lifestyle modifications to maintain her current non-elevated blood pressure status, rather than initiating pharmacological treatment. Regular monitoring of blood pressure and cardiovascular risk factors is also essential to ensure that any changes in her condition are promptly addressed.
From the Research
Blood Pressure Recommendations
The blood pressure recommendation for a 69-year-old healthy woman with no cardiovascular disease risk factors is not explicitly stated in the provided studies. However, some studies provide general guidelines for blood pressure control:
- According to 2, the recommended blood pressure levels are <140/90 mmHg for uncomplicated hypertension and <130/80 mmHg for patients with diabetes mellitus or renal disease.
- The study 3 mentions that the current treatment threshold for hypertensive adults without diabetes or cardiovascular or renal disease is blood pressure above 160/100 mmHg or 160/90 mmHg.
Risk Factors and Blood Pressure
Some studies discuss the relationship between risk factors and blood pressure:
- The study 4 found that only 23.4% of participants correctly recognized blood pressure target values.
- The study 5 reports a high prevalence of cardiometabolic risk factors, including uncontrolled blood pressure ≥140/90 mm Hg, among women considered low risk by traditional risk assessment.
Cardiovascular Disease Risk Prediction
The study 6 assesses the accuracy of cardiovascular disease prediction using female-specific risk factors in women aged 45 to 69 years, but does not provide specific blood pressure recommendations for this age group. Some key points from this study include:
- The addition of female-specific risk factors did not significantly improve the prediction of cardiovascular disease risk.
- The study suggests that these factors should not be used to reclassify risk in women aged 45 to 69 years when considering whether to commence a blood pressure or lipid-lowering medication.