Individualizing Blood Pressure Goals in Older Adults: A Podcast with Mitra Jamshidian, Simon Ascher and Mark Supiano

Individualizing Blood Pressure Goals in Older Adults: A Podcast with Mitra Jamshidian, Simon Ascher and Mark Supiano

Author: Alex Smith, Eric Widera July 10, 2025 Duration: 46:41

What's the ideal blood pressure target for older adults with hypertension? Should we aim for a systolic BP of 120 mmHg in all older adults, as suggested by the SPRINT trial? Or should we be more flexible—especially for those who are frail or among the oldest old?

This week on the GeriPal Podcast, we explore the nuances of managing blood pressure in older adults with our guests Dr. Mark Supiano, Dr. Mitra Jamshidian, and Dr. Simon Ascher. 

Now, some of our astute GeriPal listeners may say, "wait, didn't you already talk about this with Mark Supiano in a 2017 podcast titled How Low Should We Go with Blood Pressure in Older Adults?"  Yes, we sure did, but we decided to revisit this topic as Mitra Jamshidian and Simon Ascher published a new JAGS research study focused on developing a framework to individualize the net benefit of intensive blood pressure control based on the results of the SPRINT trial.  Their key finding: most community-dwelling older adults in the SPRINT trial experienced greater benefits than harms from more aggressive blood pressure targets—even those who were older, frail, or on multiple medications.

Join us for an in-depth discussion on balancing risks, benefits, and patient preferences in hypertension management for older adults. Plus, we might just sneak in a little Frank Sinatra for good measure.


Hosted by UCSF physicians Alex Smith and Eric Widera, GeriPal-A Geriatrics and Palliative Medicine Podcast creates a vital space for conversation at the intersection of aging and serious illness care. This isn't a dry lecture series; it's a dynamic dialogue where Eric and Alex bring on leading experts to unpack the complexities of geriatric and palliative medicine. They delve into the latest research that should change practice, tackle the ethical dilemmas that provoke debate, and explore the nuanced clinical challenges that professionals face daily. The tone is engaging and often surprisingly lighthearted, with moments of humor and even the occasional song, making profound topics more accessible. Whether you're a clinician, nurse, social worker, or any professional dedicated to this field, this podcast offers a blend of evidence-based insights and practical wisdom you can use. It’s a resource that acknowledges the weight of the work while fostering connection and continued learning. For those seeking formal education credits, AMA PRA Category 1 CME and MOC credit are also available through the show. Tune in to join a community committed to improving care for older adults and those with serious illness.
Author: Language: English Episodes: 100

GeriPal - A Geriatrics and Palliative Medicine Podcast
Podcast Episodes
What instead? Alternatives to Beers: Todd Semla and Mike Steinman [not-audio_url] [/not-audio_url]

Duration: 44:38
On a prior podcast we talked with Todd Semla and Mike Steinman about the update to the AGS Beers Criteria of potentially inappropriate medications in older adults (Todd and Mike co-chair the AGS Beers Criteria Panel). On…
We Need a Care Revolution: Victor Montori [not-audio_url] [/not-audio_url]

Duration: 47:41
In his book, "Why We Revolt," Victor Montori decries the industrialization of healthcare. We've become a healthcare factory, beholden to health systems motivated by profit. In particular, he laments the loss of the "care…
Death Anxiety: Dani Chammas & Keri Brenner [not-audio_url] [/not-audio_url]

Duration: 1:00:23
What is death anxiety? We spend the first 15 minutes of the podcast addressing this question. And maybe this was unfair to our guests, the fabulous dynamic duo of palliative psychiatrists Dani Chammas and Keri Brenner (l…
Health and Wealth Shocks: Lauren Hunt, Rebecca Rodin, Tsai-Chin Cho [not-audio_url] [/not-audio_url]

Duration: 44:35
June Lunney famously characterized the end of life functional course of people with dementia as a slow dwindle over time. Tom Gill later found that people with dementia do indeed have persistent severe disability through…