2019 Chinese guideline for the management of hypertension in the elderly.

1.1. Class of recommendations and level of evidences The class of recommendations and level of evidences are listed in the Tables 1 & 2. Table 1. Class of recommendations. Classes of recommendations Definitions Suggested wording to use Class I Evidence and/or general agreement that a given treatment or procedure is beneficial, useful, effective. Is recommended/is indicated. Class II Conflicting evidence and/or a divergence of opinion about the usefulness/efficacy of the given treatment or procedure. Class IIa Weight of evidence/opinion is in favor of usefulness/efficacy. Should be considered. Class IIb Usefulness/efficacy is less well established by evidence/opinion. May be considered. Class III Evidence or general agreement that the given treatment or procedure is not useful/effective, and in some cases may be harmful. Is not recommended. Open in a separate window Table 2. Levels of evidences. Level of evidence A Data derived from multiple randomized clinical trials or meta-analyses. Level of evidence B Data derived from a single randomized clinical trial or large non-randomized studies. Level of evidence C Consensus of opinion of the experts and/or small studies, retrospective studies, registries. Open in a separate window 1.2. Definition and categories of hypertension in the elderly Hypertension in the elderly is defined as systolic blood pressure (SBP) ≥ 140 mmHg and/or diastolic blood pressure (DBP) ≥ 90 mmHg measured three times in different days among patients aged ≥ 65 years without any previous antihypertensive drugs treatment. If elderly patients have hypertension history, and they are now receiving antihypertensive drugs therapy, they should be diagnosed with hypertension in the elderly though the blood pressure (BP) < 140/90 mmHg. The categories of geriatric hypertension are the same with the categories of hypertension in adults (Table 3). Table 3. Categories of BP and definitions of hypertension grade in the elderly.[1] Categories SBP, mmHg DBP, mmHg Optimal < 120 and < 80 High Normal 120–139 and (or) 80–89 Hypertension ≥ 140 and (or) ≥ 90 Grade 1 hypertension 140–159 and (or) 90–99 Grade 2 hypertension 160–179 and (or) 100–109 Grade 3 hypertension ≥ 180 and (or) ≥ 110 Isolated systolic hypertension ≥ 140 and < 90 Open in a separate window BP category is defined by the highest level of BP, whether systolic or diastolic. Isolated systolic hypertension is graded according to SBP values. BP: blood pressure; DBP: diastolic blood pressure; SBP: systolic blood pressure.