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In This Episode:
Dr. K addresses the question “What should my blood pressure be?” for older adults. In this episode she covers:
- Why an expert group recommended a higher blood pressure (BP) treatment goal for older adults in late 2013
- Whether the newer blood pressure research (known as the SPRINT trial) means you should change your blood pressure treatment
- Why the usual ways of measuring BP in the doctor’s office are flawed, and how to better measure BP
- Why she recommends a certain BP goal for most older adults, and how seniors can decide if they want to aim for a lower BP goal
Related episode:
016 – 3 Reasons to Have a Home Blood Pressure Monitor
Related Resources:
- 3 Ways Home Blood Pressure Monitors Help Older Adults
- Can This Treatment Help Me? There’s a Statistic for That (NY Times article about the number-needed-to-treat)
- What the New Blood Pressure Guidelines — & Research — Mean For Older Adults
- New Blood Pressure Study: What to Know About SPRINT-Senior & Other Research
- 6 Steps to Better High Blood Pressure Treatment for Older Adults
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Dorothy Sholeen says
Love the show.. My husband developed an enlarged and weak heart over time with no apparent cause. His ejection factor was 30-35. He started Metroprolol and Lisinopril and stopped exercise.. After 3 months his ejection factor improved to 40-45 and then in 6 months, 50-55. He continues to improve and has restarted his usual level of walking and gardening. My question is, will be need to be on medication for the rest of his life, or can he stop now that his heart is back to normal given your criteria of BP ok around 14o-150 which is where is PB was? He will have one more echocardiogram in 2 months. It will have been 16 months since the problem was discovered.
Leslie Kernisan, MD MPH says
The “enlarged and weak heart” you describe sounds like systolic heart failure (sometimes called congestive heart failure). Also sounds like your husband’s heart function has improved over the past year, which does happen.
Current or past heart failure is one of those conditions that creates special considerations when it comes to BP. (People with systolic heart failure were excluded from the SPRING blood pressure trial.) So I would recommend discussing this with the cardiologist. You could also consider a second opinion. Generally what medications your husband should continue on will depend in part on why he developed the heart failure in the first place, how his body seems to respond to a given level of BP control, and then perhaps on what research has found is effective in preventing future heart decompensation in patients like him.
Regardless of what the cardiologists recommend in terms of medications, it is always a good idea to have a home BP monitor so that you can provide more information on what his BP usually is. A home BP monitor can also come in handy if he ever feels unwell and you have to call the advice line.
Good luck, and thank you for letting me know you’re enjoying the show!