Table 7 Categories for blood pressure management based on health and functional status in older adults aged ≥75 years^a

	Category 1 Preserved ADLs; able to attend outpatient visits independently.	Category 2 Reduced instrumental ADLs; assistance needed for outpatient visits.	Category 3 Reduced basic ADLs; unable to attend outpatient visits.	Category 4 end-of-life stage
General health status	Fit to frail	Frail to needing care	Needing care	End-of-life
Instrumental ADL^b	Maintained	Reduced	Severely reduced
Basic ADL^c	Maintained	Maintained to reduced	Reduced	Severely reduced
Blood pressure targets	<130/80 mmHg	Target systolic BP < 140 mmHg; however, a more intensive target of <130 mmHg may be considered based on individual comorbidities and clinical context.	Target systolic BP < 150 mmHg; further lowering should be considered on an individual basis depending on comorbidities, but reduction to <120 mmHg should be avoided.	Individualized decision (with a reference range of systolic BP between 140 and 160 mmHg).
Other approaches	Management strategy similar to that for non-elderly individuals.	Consider tapering antihypertensive medication when systolic BP falls below 120 mmHg.		Consider stepwise dose reduction or withdrawal of antihypertensive agents; initiation of treatment is not recommended in previously untreated individuals.

Translated and adapted from ref. [2]
ADL activities of daily living, BP blood pressure
^aThe recommendations in this table also apply to older adults aged 65–74 years with declining health and functional status
^bInstrumental ADLs, which require greater complexity and effort—such as shopping, meal preparation, medication management, financial management, and use of public transportation—are assessed using tools such as the Lawton scale
^cBasic ADLs, including mobility, stair climbing, bathing, toileting, eating, dressing, and continence, are assessed using tools such as the Barthel Index

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