New guidelines suggest that people over 60 can have a higher blood pressure than previously recommended before starting treatment to lower it. The advice, criticized by some physicians, changes treatment goals that have been in place for more than 30 years.

Until now, people were told to strive for blood pressures below 140/90, with some taking multiple drugs to achieve that goal. But the guidelines committee, which spent five years reviewing evidence, concluded that the goal for people over 60 should be a systolic pressure of less than 150. And the diastolic goal should remain less than 90.

Systolic blood pressure, the top number, indicates the pressure on blood vessels when the heart contracts. Diastolic, the bottom number, refers to pressure on blood vessels when the heart relaxes between beats.

Essentially, the committee determined that there was not strong evidence for the blood pressure targets that had been guiding treatment, and that there were risks associated with the medications used to bring pressures down.