From the Guidelines
A blood pressure of 144/82 mmHg for a 72-year-old asymptomatic male is considered stage 1 hypertension and may require lifestyle modifications or medication to reduce the risk of cardiovascular disease, as indicated by the guidelines from the American Heart Association/American Stroke Association 1. The patient's systolic blood pressure is above the ideal range, while the diastolic pressure is within acceptable limits. According to the guidelines, individuals with stage 1 hypertension (systolic blood pressure between 140-159 mmHg or diastolic blood pressure between 90-99 mmHg) may be started on thiazide-type diuretics for most, and other drugs such as ACE inhibitors, angiotensin receptor blockers, beta-blockers, or calcium channel blockers may be considered as needed 1. Some key points to consider in managing this patient's blood pressure include:
- Lifestyle modifications such as weight reduction, limitation of alcohol intake, increased aerobic physical activity, reduction of sodium intake, maintenance of adequate dietary potassium, smoking cessation, and following a heart-healthy diet like the DASH diet 1
- Regular blood pressure monitoring at home to track patterns and provide more comprehensive data for the doctor
- Consideration of the patient's individual circumstances, such as the presence of compelling indications (e.g. congestive heart failure, myocardial infarction, diabetes, chronic renal failure, or prior stroke) that may require more aggressive blood pressure management 1 It is essential to discuss this reading with a healthcare provider to determine the best course of action, as controlling blood pressure is crucial to reducing the risk of heart disease, stroke, and kidney problems over time, especially in older adults.
From the Research
Blood Pressure Guidelines
- The blood pressure reading of 144/82 for a 72-year-old male who is asymptomatic can be evaluated based on various studies 2, 3, 4, 5.
- According to the study by 2, high blood pressure is a manifestation of structural and physiologic abnormalities of arterial function, and elevated systolic blood pressure and diastolic blood pressure increase the risk of cardiovascular events.
- The American Heart Association recommends that adults aged 60 and older aim for a blood pressure of less than 150/90 mmHg, while adults under 60 should aim for a blood pressure of less than 140/90 mmHg, however this information is not present in the provided studies.
Treatment of Hypertension
- The study by 6 discusses the use of combination therapy for the treatment of hypertension, including the use of thiazide diuretics, calcium channel blockers, angiotensin-converting enzyme inhibitors (ACEIs), and angiotensin receptor blockers (ARBs).
- The study by 3 investigates the efficacy of different combinations of antihypertensive therapy on blood pressure and arterial stiffness, and finds that various combinations of medications are effective in reducing blood pressure.
- The study by 4 compares the efficacy and tolerability of two combination therapies, amlodipine plus valsartan and lisinopril plus hydrochlorothiazide, in patients with stage 2 hypertension.
- The study by 5 examines the efficacy and predictors of response to the combination of amlodipine and lisinopril in patients with essential hypertension.
Evaluation of Blood Pressure Reading
- Based on the studies provided, a blood pressure reading of 144/82 for a 72-year-old male who is asymptomatic may be considered elevated, but the decision to treat would depend on various factors, including the patient's medical history, lifestyle, and other health conditions 2.
- The studies suggest that treatment of hypertension is important to reduce the risk of cardiovascular events, and that combination therapy may be effective in achieving blood pressure goals 6, 3, 4, 5.