Systolic BP 'most use in over-50s'

GPs should only use systolic BP to measure and diagnose hypertension in the over-50s, leading experts have advised.

Current NICE guidance recommends that GPs measure both systolic and diastolic BP when identifying patients with hypertension, defined as a BP above 140/90mmHg.

But, writing in The Lancet this week, three leading hypertension experts suggest that only measurements of systolic BP are needed for patients over 50, as diastolic BP declines after the age of 50.

Systolic BP is also more easily and accurately measured than diastolic BP and is a better predictor of risk, they claim.

Lead author Professor Bryan Williams, from the University of Leicester School of Medicine, and a member of the British Hypertension Society, said treatment needs to evolve with the population treated.

'Almost all patients over the age of 50 have systolic hypertension,' he said. 'It is illogical to target treatment at diastolic BP in this age group when it is falling, at a time when systolic BP is rising.'

An emphasis on a single number - systolic BP - will simplify treatment strategies and improve treatment, said Professor Williams.

No revisions to guidelines are necessary as this is simply a clarification of objectives within existing treatment frameworks, said Professor Williams.

Additionally, GPs should continue measuring both systolic and diastolic BP in patients under the age of 50, as 40 per cent of patients in this age group will have isolated diastolic hypertension, say the experts.

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