Cardiovasc Prev Pharmacother.  2024 Jan;6(1):17-25. 10.36011/cpp.2024.6.e3.

Recent evidence on target blood pressure in patients with hypertension

• Kim HL

• KMID: 2551340
• DOI: http://doi.org/10.36011/cpp.2024.6.e3

Abstract

Hypertension is a significant risk factor for a variety of cardiovascular diseases, including stroke, coronary artery disease, heart failure, and peripheral arterial disease. Achieving and maintaining a specific target blood pressure (BP) is crucial for effectively reducing the risk associated with these conditions. This involves customizing treatments to meet the individual needs of patients with hypertension, ensuring that each person receives the most appropriate care for their particular circumstances. Previously, based on the findings from the ACCORD (Action to Control Cardiovascular Risk in Diabetes) study conducted over the past decade, the target BP for patients with hypertension was set at <140/90 mmHg, regardless of the patient's risk profile. However, new insights from reanalyzed data of studies such as the SPRINT (Systolic Blood Pressure Intervention Trial), the STEP (Strategy of Blood Pressure Intervention in the Elderly Hypertensive Patients) study, and ACCORD subgroup reanalysis have led to a change in this approach. These studies support a more aggressive target BP of <130/80 mmHg, especially for high-risk patients. The purpose of this article is to offer a thorough review of these updated recommendations and to explain the reasoning behind the revised target BP guidelines for individuals with hypertension.

Keyword

Heart disease risk factors; Blood pressure; Hypertension

Figure

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  Fig. 1. Target blood pressure. a)Risk factors: age (male ≥45 years, female ≥55 years), family history of early cardiovascular/cerebrovascular disease (male <55 years, female <65 years), smoking, obesity, dyslipidemia, prediabetes and diabetes mellitus. b)Target organ damage: periventricular white matter hyperintensity, microbleeds, asymptomatic stroke, left ventricular hypertrophy, albuminuria, low glomerural filtration rate, atheromatous plaque, carotid-femoral pulse wave velocity >10 m/sec, brachial-ankle pulse wave velocity >18 m/sec, coronary artery calcium score ≥400, hypertensive retinopathy (grade ≥3).

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