New Hypertension Guidelines Potentially Affect Millions of Americans Interview with:
Ann Marie Navar-Boggan, MD, PhD
Division of Cardiology,
Duke University Medical Center
Durham, North Carolina What are the main findings of the study?

Dr. Navar-Boggan: Two groups of adults are really affected by the updated guidelines. First, 13.5 million adults, including one in five adults over the age of 60, were previously considered to have uncontrolled blood pressure but now meet new guideline goals.

Next, 14 million adults over the age of 60 (one in four adults in this age group) are currently on blood pressure lowering therapy and meeting the older, more stringent targets. The guidelines state that no changes are necessary in this group, but they may be eligible for reduced therapy, particularly if they have had side effects or difficulty with the therapies they are taking. Were any of the findings unexpected?

Dr. Navar-Boggan: Given the high rate of hypertension in older adults, we suspected that the change in guidelines would have a significant impact. Although not unexpected, it is still impressive that even under the less stringent new blood pressure guidelines, 27 million Americans still have uncontrolled blood pressure. What should clinicians and patients take away from your report?

Dr. Navar-Boggan: Physicians should know that there is a large number of adults who were previously considered to have uncontrolled blood pressure who no longer are considered above goal. Millions of older adults fall into the grey area of a systolic blood pressure between 140 and 150. Given the lack of consensus among experts on the new guideline recommendation to raise the BP goal in older adults over the age of 60, clinicians should use the release of the new guidelines as a reason to have individual discussions with their older patients regarding the potential risks and benefits of different blood pressure goals. What recommendations do you have for future research as a result of this study?

Dr. Navar-Boggan: Future research should target two main areas: First, what is the optimal blood pressure target in older adults in the US, and second, how will the change in guidelines impact the overall blood pressure levels in adults in the US, and will this impact rates of cardiovascular disease?

Finally, given that the number of individuals with uncontrolled hypertension remains high, and that half of those adults with uncontrolled blood pressure are untreated, we need continued, aggressive efforts to diagnose and treat adults with hypertension.


Navar-Boggan A, Pencina MJ, Williams K, Sniderman AD, Peterson ED. Proportion of US Adults Potentially Affected by the 2014 Hypertension Guideline. JAMA. 2014;():. doi:10.1001/jama.2014.2531.


Last Updated on March 29, 2014 by Marie Benz MD FAAD