Risk-Guided Treatment Criteria Alters Eligibility for Stage I HTN Treatment

TUESDAY, March 17, 2026 (HealthDay News) -- Using the 2025 risk-guided criteria, 11.4 percent of untreated older adults with stage 1 hypertension would not be eligible for treatment, according to a research letter published online March 17 in the Annals of Internal Medicine.Sridhar Mangalesh, M.D., from the Albert Einstein College of Medicine in Bronx, New York, and colleagues examined the effect of the 2025 hypertension guideline, which introduced risk equations for guiding treatment decisions, by assessing how risk-guided therapy would affect pharmacotherapy recommendations for individuals aged 65 years or older. The cross-sectional analysis included adults aged 65 to 79 years from the January 2013 to March 2020 cycles of the National Health and Nutrition Examination Survey.The researchers found that 169 of 2,099 older adults had untreated stage 1 hypertension. Under previous guidelines, all 169 would have been eligible for treatment, but only 156 (88.6 percent) were eligible for immediate pharmacotherapy under current guidelines; 11.4 percent were reclassified out of automatic age-based eligibility. All those who were considered ineligible under the 2025 guidelines were female, nonsmokers, aged 65 to 68 years, and had total cholesterol of 4.0 to 6.8 mmol/L, high-density lipoprotein cholesterol of 1.2 to 2.3 mmol/L, body mass index of 20 to 36 kg/m2, estimated glomerular filtration rate of 73 to 99 mL/min/1.73 m2‑, systolic blood pressure of 114 to 136 mm Hg, and PREVENT risk from 4.8 to 7.4 percent."Our findings among older adults underscore the guideline shift toward personalized, risk-based care," the authors write.Abstract/Full Text (subscription or payment may be required).Sign up for our weekly HealthDay newsletter

Risk-Guided Treatment Criteria Alters Eligibility for Stage I HTN Treatment

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