What is the recommended blood pressure (BP) goal for patients over age 60?

The recommended blood pressure goal for patients over age 60 is generally considered to be 150/90 mmHg. This guideline is informed by research indicating that in older adults, the risks associated with hypertension need to balance with the risks of aggressive blood pressure lowering. Maintaining a systolic blood pressure goal of 150 mmHg helps to reduce the risk of cardiovascular events while minimizing the potential for adverse effects from overtreatment, such as falls and acute kidney injury, which can be significant concerns in this age group.

Patients over 60 years old often have age-related physiological changes, including increased stiffness of arteries, which can lead to a higher baseline blood pressure. Guidelines suggest that a target of 150/90 mmHg is appropriate as it aims to decrease the overall risk of cardiovascular disease and related complications without introducing undue risk through aggressive lowering of blood pressure.

While maintaining optimal blood pressure levels is important, treating to a lower target such as 130/80 may not demonstrate significant additional benefit in older populations and can lead to complications if aggressive therapy is employed. Thus, the goal of 150/90 is seen as a thoughtful compromise that helps guide appropriate management of hypertension in older adults.