A Case for Less Intensive Blood Pressure Control: It Matters to Achieve Target Blood Pressure Early and Sustained Below 140/90mmHg.
Although high blood pressure (BP) is the leading risk factors for cardiovascular (CV) disease, the optimal BP treatment target in order to reduce CV risk is unclear in the aftermath of the SPRINT study. The aim of this review is to assess large, randomized, and controlled trials on BP targets, as well as review selected observational analyses from other large randomized BP trials in order to evaluate the benefit of intense vs. standard BP control. None of the studies, except SPRINT, favored intense BP treatment. Some of the studies suggested favorable effects of lowering treatment target in patients with diabetes or high risk of stroke. In SPRINT, a new BP measurement method was introduced, and the results must be interpreted in light of this. The results of the observational analyses indicated the best preventive effect when achieving early and sustained BP control rather than low targets. In conclusion, today's guidelines' recommended treatment target of <140/90mmHg seems sufficient for most patients. Early and sustained BP control should be the main focus.
Faculty of Medicine, University of Oslo, Oslo, Norway.
Julian E
JE
Mariampillai
Faculty of Medicine, University of Oslo, Oslo, Norway.
Per Anders
PA
Eskås
Faculty of Medicine, University of Oslo, Oslo, Norway.
Sondre
S
Heimark
Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Cardiology, Oslo University Hospital, Ullevaal, Oslo, Norway. Electronic address: s.e.kjeldsen@medisin.uio.no.
Sverre E
SE
Kjeldsen
Department of Hypertension and Diabetology, Medical University of Gdansk, Poland.
Krzysztof
K
Narkiewicz
IRCCS Instituto Auxologico Italiano, University of Milano-Bicocca, Milan, Italy.
Giuseppe
G
Mancia
D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D010347:Patient Care Planning
D000959:Antihypertensive Agents
Blood pressure; Blood pressure target; Cardiovascular disease; Clinical trial; Hypertension