Sharp Rees-Stealy cardiologist featured in Journal of the American College of Cardiology to address potential negative impact of new blood pressure recommendations on African Americans and women.
Dr. Robert Gillespie, a cardiologist with Sharp Rees-Stealy Medical Group, co-authored an article on behalf of the Association of Black Cardiologists (ABC), raising concerns about new blood pressure recommendations and their potential significant negative impact on at-risk populations, including African Americans and women who are 60 years of age or older. The article will appear in the July 29 issue of Journal of the American College of Cardiology.
The recommendations, which have been promoted and accepted by some as an official guideline, would change blood pressure treatment targets among patients who are 60 or older from the existing goal of 140/90 or lower to 150/90 or lower, impacting patients who would have been considered for medication under previous guidelines.
"High blood pressure and heart disease affect both the older populations of African Americans and women at significantly higher rates compared to the general population," said Gillespie. "If accepted as a guideline, these recommendations could undermine the progress that has been made over the last several decades in managing these conditions, particularly in minority at-risk populations."
The recommendations were written by panel members appointed to the Joint National Committee-8 Panel (JNC-8P). The panel was assembled by the National Heart Lung and Blood Institute, but the final report was submitted for publication by the panel members and does not have the official backing of any government agency or medical society. Gillespie says the opinion of the ABC is that the 2014 recommendations are flawed by design, due to constraints in the research method that understate existing evidence to support a more aggressive approach to controlling blood pressure.
"These 2014 recommendations have not been sanctioned by any federal agency, which includes the National Heart, Lung and Blood Institute, and are not consistent with multiple previous international guidelines including those in the United States," said Gillespie. "Furthermore, there was considerable disagreement within the JNC-8P resulting in several members refusing to endorse the recommendations."
The ABC holds the position that clinicians who treat African Americans and other at-risk populations should await further recommendations from major professional health organizations before implementing any changes to previously accepted standards of care. The American College of Cardiology and the American Heart Association, in collaboration with other organizations, are in the process of creating a new hypertension guideline.
Additional co-authors of the article, "2014 Hypertension Recommendations From the Eighth Joint National Committee Panel Members Raise Concerns for Elderly Black and Female Populations," include Dr. Lawrence R. Krakoff, Icahn School of Medicine at Mount Sinai, New York, N.Y.; Dr. Keith C. Ferdinand, Tulane University School of Medicine, New Orleans, La.; Dr. Icilma V. Fergus, Mount Sinai Medical Center, New York, N.Y.; Dr. Ola Akinboboye, MBA, Queens Heart Institute, Rosedale, N.Y.; Dr. Kim A. Williams, Rush University Medical Center, Chicago, Ill.; Dr. Mary Norine Walsh, St. Vincent Heart Center of Indiana, Indianapolis, Ind.; Dr. C. Noel Bairey Merz, Barbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute, Los Angeles, Calif.; Dr. Carl J. Pepine, Division of Cardiology, University of Florida, Gainesville, Fla.