Ease the tension around blood pressure goals in older adults and get inside the hypertension guidelines released by the ACP and ACC/AHA in 2017 with the sagacity of Dr. Mary Ann Forciea, MD, MACP, Professor of Medicine at University of Pennsylvania. We cover: how to properly measure blood pressure, how to diagnose hypertension, blood pressure targets, why BP goals differ by society, how to guidelines are written and how to interpret them with a critical eye, plus a hot take on the 2017 ACC/AHA guidelines. Dr. Shreya Trivedi joins as cohost. Special thanks to Hannah Abrams for her wonderful infographics and to Dr Trivedi for compiling our show notes. Time Stamps 00:00 The setup 02:15 Disclaimer 03:32 Picks of the Week 08:13 Getting to know Dr Forciea 13:35 Broad overview and a clinical case of geriatric hypertension 14:45 Brief history on BP targets 18:05 How do you measure a blood pressure? What type of monitors are available? 22:13 How to standardize BP in the office? 23:55  Ambulatory BP monitoring 24:55 Home blood pressure monitoring 26:11 Standing blood pressure readings and orthostatic hypotension 27:53 How guidelines are written 30:51 Evaluating evidence quality and strength of recommendation 32:35 Timeline and process for guideline generation 34:27 How to read guidelines with a “critical eye” 36:15 Return to our case of uncontrolled hypertension 38:25 Blood pressure targets from ACP guidelines and BP management in frail older adults 40:33 Counsel patients on BP targets    42:25 Low diastolic blood pressure 45:35 SPRINT and the ACP BP guidelines 48:58 Take home points from Dr Forciea 50:07 HTN targets and pay for performance in clinical practice 51:45 Curbsiders recap the ACP guidelines 53:45 Matt and Paul recap the AHA guidelines 54:47 AHA definitions of hypertension 56:15 Diagnosing hypertension and how to measure a blood pressure 60:35 Choosing a blood pressure monitor and HBPM 62:29 Blood pressure goals in ACC guidelines 66:08 Non-pharmacologic measures 69:15 Will we follow these new strict targets? 72:45 Outro Tags:hypertension, blood, pressure, monitor, cuff, heart, aha, acc, act, stroke, cardiac, cardiovascular, event, guidelines, assistant, care, doctor, education, family, foam, foamed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student