Assessment of achieved systolic blood pressure in newly treated hypertensive patients aged 60-79 years before and after Eighth Joint National Committee recommendations.

OBJECTIVE: To determine whether patients who were newly prescribed antihypertensive therapy after the Eighth Joint National Committee (JNC 8) update were treated to a relaxed systolic blood pressure (SBP) goal compared with patients treated before the update.

METHODS: A retrospective cohort study approved by the Colorado Multiple Institutional Review Board. Patients aged 60-79 years, without diabetes or chronic kidney disease (CKD), newly treated for hypertension at a University of Colorado primary care clinics were included. The mean first-achieved and last-stable SBPs of patients newly prescribed antihypertensive medications from 1 January 2012 to 31 December 31 2013 (before cohort) were compared with patients newly prescribed antihypertensive therapy from 1 January 2014 to 1 October 2015 (after cohort). The mean number of antihypertensive medications at first-achieved SBP, the time to first-achieved SBP, and the class of initial antihypertensive medications were also evaluated.

RESULTS: A total of 128 patients were included, 64 patients in each cohort. The coprimary outcome of first-achieved mean SBP did not differ between the groups (131.3 mmHg versus 130.2 mmHg; p = 0.65). Last-stable mean SBP values were also similar between the groups (130.2 mmHg versus 129.5 mmHg; p = 0.74). Angiotensin converting enzyme inhibitors (ACE-I) were the most frequently initiated antihypertensive agent in both cohorts (43.8% versus 48.4%; p = 0.72).

CONCLUSIONS: Our findings suggest that the JNC 8 recommendations did not alter SBP goals among patients aged 60-79 years newly treated for hypertension at University of Colorado primary care clinics.