Aiming too high or too low? Searching for the appropriate therapeutic thresholds in hypertension is not over yet

Commentary on: Rodriguez CJ, Swett K, Agarwal SK, et al.. Systolic blood pressure levels among adults with hypertension and incident cardiovascular events: the Atherosclerosis Risk in Communities Study. JAMA Intern Med 2014;174:1252–61. Context Increased arterial blood pressure (BP) is an established and modifiable cardiovascular (CV) risk factor. Consequently, the decision on antihypertensive treatment has been in the focus of changing recommendations over the past decades, initially with higher accepted BP thresholds than those recommended by modern guidelines. However, recently published consensus statements have indicated that treatment goals should be less ambitious, as ‘the lower the better’ might not be applicable for ages >60 years and in uncomplicated hypertension.1 2 Moreover, the traditional definition of increased BP that warrants pharmacological treatment has been questioned since studies have suggested that elevated night-time BP, but not daily, office or self-measured BP, is a better marker of increased...
Source: Evidence-Based Medicine - Category: Internal Medicine Authors: Tags: EBM Prognosis, Epidemiologic studies, Drugs: cardiovascular system, Stroke, Hypertension, Ischaemic heart disease Source Type: research