Objective:

To evaluate the impact of the 2025 hypertension guideline on treatment eligibility for older adults aged 65 to 79 years with stage 1 hypertension.

Key Findings:

• Among 2,099 older adults, 169 had untreated stage 1 hypertension.
• Under the 2025 guideline, 11% (13 patients) were reclassified as ineligible for immediate drug therapy.
• This reclassification corresponds to an estimated 240,000 US adults aged 65 to 79 years.

Interpretation:

The shift to individualized risk assessment may significantly reduce the number of older adults automatically eligible for antihypertensive therapy, highlighting the importance of personalized care.

Limitations:

• Cross-sectional design limited the ability to determine pretreatment blood pressure for already treated patients, which may affect the generalizability of the findings.
• PREVENT risk scores for treated patients were influenced by prior antihypertensive use, complicating eligibility assessments and potentially skewing results.

Conclusion:

The findings highlight a significant change in treatment eligibility for older adults with stage 1 hypertension, aligning with a trend towards personalized, risk-based healthcare.