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Posted on 03/22/2026 5:51:24 PM PDT by SeekAndFind
For years, turning 65 with a blood pressure reading above 130 meant one thing: medication.
A new analysis of the 2025 American Heart Association guidelines shows that this practice is changing, finding that roughly 10 percent of older adults previously flagged for treatment may no longer meet the criteria, a move experts say prevents overtreatment, but one that carries its own risks.
The 2025 guidelines marked a significant departure from the 2017 AHA guidelines, which recommended treatment for all adults over 65 with blood pressure at or above 130/80 mmHg.
The updated 2025 guidelines replace that blanket approach with one that weighs a patient’s 10-year cardiovascular disease (CVD) risk, offering what experts describe as a more personalized lens on heart health.
Under the new framework, immediate medication is no longer recommended based only on age and blood pressure levels, but also with consideration of the individual’s other cardiovascular risk factors. This translates to around 1 in 10 Americans over the age of 65 with early hypertension who would no longer being recommended medication.
More than 70 million Americans are currently taking medication to lower their blood pressure and reduce their risk of heart attack and stroke. However, these drugs can sometimes cause side effects like dizziness, fatigue, and kidney problems, making the question of who truly needs treatment a consequential one.
Researchers analyzed data from 2,200 adults aged 65 to 79 with high blood pressure. They compared two groups: one that received treatment based on the 2017 guidelines, and another based on the current ones, which are guided by each person’s overall health risk profile.
They found that around 1 in 10 Americans over the age of 65 with Stage 1 hypertension would no longer be recommended medication, provided that they are otherwise healthy with no other cardiovascular risk factors.
Stage 1 hypertension is defined by blood pressure readings of 130 to 139 mmHg systolic or 80 to 89 mmHg diastolic.
The study also found that about 40 percent of older adults with high blood pressure could benefit from treatment that considers their overall health risks, not just their blood pressure numbers. This risk-guided approach could prevent overmedication of patients and thereby shield more patients from the potential side effects of blood pressure medication, while still reducing cardiovascular disease risk.
“The art now is to match the intensity of treatment to both global cardiovascular risk and the patient’s blood pressure, rather than chasing a number at all costs and treating all older patients with a ‘one size fits all’ approach,” Dr. Carolyn Lam, senior consultant cardiologist at the National Heart Center of Singapore and co-founder of AI medtech platform Us2.ai, told The Epoch Times.
In older adults, the concerns with over-aggressive blood pressure lowering include dizziness, falls, fractures, and acute kidney injury, especially in those who are frail or have chronic kidney disease, Lam noted.
The risk-guided approach, she explained, concentrates intensive treatment where the absolute benefit is greatest—typically in patients with diabetes, kidney disease, or multiple cardiometabolic risks—while avoiding unnecessary polypharmacy in lower-risk patients.
“Done well, this can reduce heart attacks, strokes, and heart failure, yet also help preserve independence and quality of life in later years,” Lam said.
“Many of these people are fragile,” he pointed out, and have blood pressure that goes up and down in a way that can be difficult to predict.
“Some of them have periods where their blood pressures go very low on their own, and then the blood pressure medication is quite difficult to use because you’re trying to abolish the high values, but you don’t want them to be exposed to low [blood pressure] values,” he said.
However, Kowey also warned that the report may have the unintended consequence of reducing treatment for those who really need it.
“I have a big problem with this,” he said. “It’s very analogous to what we’ve done with statins and LDL.”
He compared the new model for prescribing antihypertensive drugs to the risk models applied from previous guidelines on statin prescription statins and LDLs, which reduced the number of Americans that would once be candidates for statin medication by up to 40 percent.
Because the new risk model requires considering all relevant risk factors for treating high blood pressure, Kowey said a primary care doctor who is not savvy enough or doesn’t have enough time to do all the risk assessments is likely to get the wrong message.
“Which is, ‘well, I don’t have to treat this guy or this lady,’ and I think that could be a big trap,” he warned.
Kowey emphasized that he would very much not want primary care doctors to be, in the 10 minutes that they have spent with a patient, “sitting there wringing their hands about whether they should treat a blood pressure of 160 over 100 because of the risk factor issue.”
He concluded that the big challenge isn’t getting people off medications—“The big challenge here is finding all the people out there that need to be treated and giving them something that works, and that they can tolerate.”
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“1 in 10 Americans over the age of 65 with Stage 1 hypertension would no longer be recommended medication“
Doesn’t go with the title
Sounds like patents are expiring or have already expired.
All I can say is a take a pill that is approx one half
Hydrochlorothyazide (aka Water Pill) and one half Lisinopril. I after years of hypertension and elevated results, my blood pressure has remained normal nearly all of the time.
More recently, I was advised to take Apixiban BID (twice daily) to prevent strokes. At first, I was concerned that taking Apixiban would make me an ‘easy bleeder’ over very small cuts. That did not happen. If you have had the same doctor for two years or more, they just might know what you require to hold onto your optimum level of health.
My question is:
How much cholesterol in the blood going to the brain is necessary for superior brain function?
A quality of life issue.
Frequency is the future. The body’s regenerating processes just need to be activated using biotechnology like RFK Jr has been wearing and others in a wellness community with professional practicioners for support with documented studies and patents where modern medical has utterly failed. I’ve been on it 2.9 years now with amazing results since my dormant stem cells have became regenerated naturally, maximizing my quality of life.
Whatever your circumstance, measure your blood pressure at home. Let those measurements, which you will write down over a period of a week, be the number provided to the doctor for him to interpret and use in making a decision on medication. Do not use the measurement in the doctor’s office.
Oh and one other step in this process is to take your blood pressure measuring device into the office and be sure that it reads the same, which will probably be quite high. And it will be higher than you’ve ever seen it before at home.
Not sure what “frequency” you are referring to? Would you please expand on that? Thank you.
The enlarged heart was really just a shadow making it seem that way in images. The cardiology group had me on nine medications.
I did a lot of research and settled on just two. Valsartan 160mg and Carvedilol 12.5mg, twice daily. Everything improved as reflected in data, imaging, and no more terrible side effects.
My monthly RX costs went from $1,400, to $12 not using my RX insurance. I strongly recommend Amazon Pharmacy, and or the on line ordering directly from India where they make the stuff.
The Biventricular pacemaker is just fine. I no longer have two beats on one chamber and one beat on the other. They are synchronous now. BP is around 95/55. When I rise from sitting or kneeling, I have to wait 15 seconds before I start walking. It tends to drop very low for about the first 15 seconds. Falling over or passing out can happen if I don't wait and compensate for the sudden drop.
One drug they wanted me to be on turns you blue, permanently if you go out in the sun. Another puts your your testicle area at risk for necrotic infection. These drug companies conspire with doctors to prescribe everything insurance billing algorithms will permit based on age, race, weight, etc..... They will so overprescribe you to the point that it's insane. Unfortunately, you are the only one responsible for your healthcare now. Do not trust your doctors or a hospital. Your Healthcare is way at the bottom of their obligations.
Most people can get under the high blood pressure level simply by reducing salt intake. Don’t put salt on anything and limit your sodium intake from processed foods.
The “numbers” are basically CYA for physicians and money makers for pharmaceutical companies.
Follow the trend over the years of what is a “good” A1C, as an example.
On the “numbers” threshold, a 0.1 point difference separates pharmaceutical intervention from not having been prescribed a drug. Bunk.
GP and FP doctors are pressured to hit those “numbers”, especially the lipid profiles.
Talk to a Cardiologist or Endocrinologist in depth, and differences are exposed.
My opinion is that maintenance medications are greatly overprescribed.
I worked as a Pharma sales representative years ago.
Lots of what is done is good and has valid justification, but lots of what is being done is being done to satisfy what amounts to a hitting a constantly moving target lab result. Again, only my opinion.
One way to try to cut down on Social Security payouts after Fauci Flu and the Clot Shot didn’t work as well as projected.
“How much cholesterol in the blood going to the brain is necessary for superior brain function?”
If you take Statins, not much. The fact that you then get dementia is not a concern to cardiologists and primary care doctors.
I have that same exact question. Any thoughts?
“Another (drug) puts your your testicle area at risk for necrotic infection.”
Thanks, but I think I’ll pass on that drug.
“Most people can get under the high blood pressure level simply by reducing salt intake. Don’t put salt on anything and limit your sodium intake from processed foods.”
Then you die from other causes, due to insufficient salt.
Winds up that the federal recommendations are not optimal and the “sweet spot” is about twice the recommendation.
BTW, going even higher than the sweet spot will increase all-cause mortality, but at a very low slope (meaning that if you double the sweet spot amount, you will increase all-cause mortality, but not by a lot).
Bottom line: The reason that people love salt is that their body needs it. Same for fat.
In any case, I’m just a radical pro-Putin guy (according to some Leftists here), so feel free to ‘trust your doctor’.
“My opinion is that maintenance medications are greatly overprescribed.”
My very old father decided to longer take drugs, including a Thyroid drug and one for blood pressure, about 3 years ago. Every time he’s checked out, he’s doing just fine. He seems to support what you’re claiming.
I’ve got 1,902 BP measurements going back to August 1999 in my Health spreadsheet (age 58 to 74). Same protocol every time...wake, bathroom, sit in the easy chair for 10 minutes, relax, clear the mind, and then measure. I always take 3 readings from 1 to 10 minutes apart and enter all three in my spreadsheet. A simple Pivot Table and charts show key trends.
Sometimes I measure a few times a month, other times I measure every day for a week or two. Do it yourself with a strong, consistent protocol like that and you avoid the “white coat syndrome” you get in the doctor’s office.
The data are a great guide to treatment. I can tie my BP to my weight, my exercise regimen, cumulative exercise METS expended, and to different meds and doses that have been used.
It takes a bit of your own time to do this “longititudinal” analysis, but it is very worthwhile to optimize treatment.
I’ve got a “User Defined Function” in Excel that calculates a weighted average of my weight before and after any date in Excel. That way I can add my averaged weight to my BP data. I can see the strong correlation of weight to BP.
I met with my GP last Friday to review new lab results (first labs after losing 34 pounds from 7/25/25) and meeting with my cardiologist tomorrow. I’m hoping to adjust dosages down or maybe eliminate one or two BP meds entirely.
“Unfortunately, you are the only one responsible for your healthcare now. “
Probably true before covid.
Now it should be extremely clear.
weight loss to normal is the most effective remedy for heart failure and hypertension. I lost 81lb 9 years ago and they canceled the pacemaker and the ablation that were schedule. My BP this minute is 94/67.
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