CNN：So you have high blood pressure? New guidelines suggest maybe you don’t

New guidelines for the management of hypertension suggest that people 60 or older might be able to handle higher blood pressure readings than originally thought.

Hypertension, which can lead to strokes, heart attack, kidney failure and death, is traditionally treated with medication and diet.

The goal of most doctors is to keep their patient’s blood pressure below 140 (systolic) / 90 (diastolic). But after reviewing mounds of evidence, a committee of experts now says the systolic number, especially in older people, can be higher at 150/90. And many of these patients who were on medication would no longer need to be.

It is not clear how many people would be affected by these new guidelines, but experts are estimating in the millions.

The committee was asked to update the guidelines that have been in place for more than 30 years. They were published online Wednesday in the latest edition of the Journal of the American Medical Association.

The group of 17 experts found no reason to change any other section of the guidelines.

According to the report, “There is strong evidence to support treating hypertensive persons aged 60 years or older to a BP goal of less than 150/90 and hypertensive persons 30 through 59 years of age to a diastolic goal of less than 90.

“However, there is insufficient evidence in hypertensive persons younger than 60 years for a systolic goal, or in those younger than 30 years for a diastolic goal, so the panel recommends a BP of less than 140/90 for those groups based on expert opinion.”

聯合報中文報導：

美國醫學會期刊公布新準則，把60歲以上老年人的高血壓標準放寬，建議收縮壓超過150毫米汞柱（mmHg）、舒張壓超過90毫米汞柱才需要藥物治療；不過，有些醫師對此持異議。

現行醫學準則界定，收縮壓超過140毫米汞柱、舒張壓超過90毫米汞柱就算高血壓。醫師據此建議病人雙管齊下，服用藥物及改變生活方式（運動、減肥、少吃鹽分）降低血壓。

新準則只針對60歲以上的老年人，年齡在30歲至59歲者，仍維持140/90以下。

醫學報告指出，從隨機蒐集的證據顯示，把60歲以上族群的血壓降到150/90以下，可減少中風、心臟衰竭、心臟病發作機率。 但研究人員未建議病人停止目前服用的高血壓藥物，因為突然停止服用可能導致嚴重副作用。

評論：

人體是一個複雜的系統，本來就不能以單一現象或數值來判斷健康。每一個人的個體差異也很大，就好像每一個人腳的大小都不一樣，不會因為數據統計成人鞋子平均穿10號，我們就要求所有人買10號的鞋子，更何況這個10號鞋子的數據統計是根據美國做的，那亞洲人的鞋子平均也是10號嗎？