Personalizing "Lower is Better" for Blood Pressure Treatment, from the May 2014 Harvard Men's Health Watch

Share Article

Taking multiple medications, poor health, and older age can make aggressive drug therapy for high blood pressure riskier.

News Image

Many men with high blood pressure were surprised—and a little confused—when a panel of experts convened by the National Institutes of Health recommended a change in the treatment goal for people over age 60. Instead of taking medications to lower pressures to 140/90, they can now settle for a target of 150/90. Several factors come into play when deciding on the best blood pressure target, reports the May 2014 Harvard Men's Health Watch.

The ideal blood pressure is under 120/80. As it rises above that threshold, the risk of heart attacks, strokes, and other health problems follows. Above 140/90, doctors generally recommend starting treatment.

For men at any age, a lower blood pressure goal for treatment is better—if they can take medications safely. "It doesn't depend on an arbitrary age," says Dr. Lipsitz, chief of geriatrics at Harvard-affiliated Beth Israel Deaconess Medical Center. "In the end, the goal of treatment—the target pressure a man should shoot for—depends on his overall health."

The amount of disease-prevention bang individuals get for their medication buck depends on their starting risks of having a heart attack or stroke. If the risk is high, there's more to gain from medication. If the risk is relatively low, medication may not help that much.

Taking three or four different medications to reach an arbitrary blood pressure target could cause dangerous side effects, especially dizziness leading to falls. Such problems are likely to appear within the first few weeks or months of taking blood pressure drugs, when the body is adjusting to them.

"It's safest to start low and go slow," Dr. Lipsitz says. "If a man starts at a small medication dose and gradually increase it over time, the body adjusts better."

Read the full-length article: "Blood pressure goals: How low should you go?"

Also in the May 2014 issue of the Harvard Men's Health Watch:

  •     The best repair for a hernia
  •     Tips to breathe away stress in 20 minutes
  •     Using laxatives safely
  •     Dietary supplements that may cause prostate cancer.

The Harvard Men's Health Watch is available from Harvard Health Publications, the publishing division of Harvard Medical School, for $20 per year. Subscribe at or by calling 877-649-9457 (toll-free).

Media: Contact Kristen Rapoza at hhpmedia(at)hms(dot)harvard(dot)edu for a complimentary copy of the newsletter, or to receive our press releases directly.

Share article on social media or email:

View article via:

Pdf Print

Contact Author

Kristen Rapoza
Harvard Health Publications
+1 (617) 432-4716
Email >
Follow >
Visit website