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Comment & Response
February 2018

Inconsistent Hypertension Guidelines: We Need a Little Help Here

Author Affiliations
  • 1Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
  • 2Family Medicine Residency Program, Abington Jefferson Health, Abingdon, Pennsylvania
JAMA Intern Med. 2018;178(2):297-298. doi:10.1001/jamainternmed.2017.8309

To the Editor My colleagues and I in primary care are figuring out what to do with the hypertension guidelines announced in November 2017.1 The guidelines were endorsed by the American College of Cardiology, American Heart Association, American Society for Hypertension, and almost every other cardiology organization in existence.1 Notably missing among the organizations endorsing the guidelines were the 2 primary care organizations that represent the majority of physicians who actually treat hypertension everyday: the American Academy of Family Physicians (AAFP) and the American College of Physicians (ACP). These organizations issued their own guidelines 6 months earlier, with recommendations for blood pressure management of adults older than 60 years. Those guidelines recommend a target systolic blood pressure of less than 150 mm Hg—distinctly different from the target recommended by the new joint statement, which recommends a target less than 130 mm Hg.2 This remarkable lack of consensus complicates the decision-making process for practicing clinicians and creates confusion.

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