Pharmacologic Treatment of Hypertension in Adults Aged 60 Years or Older to Higher Versus Lower Blood Pressure Targets: A Clinical Practice Guideline From the American College of Physicians and the American Academy of Family Physicians as originally seen in The Annals of Internal Medicine
A new clinical practice guideline for the pharmacologic management of high blood pressure has hit the waves. As therapists, we have no control over what a physician prescribes for blood pressure management… or do we?
No, we don’t have a drug prescription pad– we have home exercise program prescriptions instead. As seen in the video above, getting more physical activity helps to control blood pressure. So we can recommend that our patients get the minimum amount of exercise daily to help maintain heart health– 30 minutes most days of the week doing whatever activity the person who’s doing the work chooses that will get the heart pumping at a level to where it is slightly difficult to keep up an on going conversation. Making a lifestyle change is much more difficult than popping a pill, BUT the only side effects it comes with are positive ones– improved lung capacity to make you talk louder, shop longer/faster; improved overall strength so you can keep bowling on Saturday, etc.
It is also our responsibility as medical professionals to check our patients’ blood pressure at EVERY appointment. The physicians might see their patients a couple times a year. A typical therapy plan of care requires we see our patients at least once a week, usually more, while under our care. Sometimes we see also see them at varying time of the day. This means that we have more opportunity to spot a problem with blood pressure before it becomes an emergency than many other health care professionals do. Just do it. It literally takes 1-2 minutes out of your session. You could save your patient’s life. If you spot a problem, please refer the patient back to their physician as quickly as possible. Don’t just tell the patient to do it; call the physician yourself and tell them what’s going on.
What’s important in the new guidelines for us is the goal numbers we should be reaching for have changed. For folk over 60 with a history of stroke or heart attack, we should be aiming to get the systolic BELOW 140. For those over 60 with no history of those, we should be aiming for BELOW 150. We’re moving away from one-size-fits-all (which I lovingly call “one-size-fits-none”) medicine and into more specific practice. Hooray!