english.prescrire.org > Spotlight > Archives : 2010 > Treating hypertension: blood pressure targets should be tailored to each patient

Spotlight: Archives

Every month, the subjects in Prescrire’s Spotlight.

2010 : 1 | 30 | 60 | 90

Treating hypertension: blood pressure targets should be tailored to each patient

In patients without diabetes or cardiovascular complications whose blood pressure is above 160/95 mm Hg, the usual goal of treatment is to reduce the blood pressure to below 140/90 mm Hg. But this should be adjusted in light of the patient’s clinical circumstances and preferences, since numerous trials have shown that reducing blood pressure even to 150/90 mm Hg is beneficial.

In adults with hypertension, i.e. with blood pressure of 160/95 mm Hg or higher, with no diabetes or cardiovascular complications, an antihypertensive treatment is warranted. Targeting a blood pressure of 150/90 mm Hg is supported by the results of a number of clinical trials. Overall, this prevents 2 to 10 cardiovascular events per 1000 patients treated for 2 to 6 years with tried-and-tested drugs (starting with the diuretics chlortalidone or hydrochlorothiazide).

Aiming for a blood pressure below 140/90 mm Hg in patients without cardiovascular complications or diabetes probably makes it possible to prevent a few further cardiovascular events, although this has not been formally proven.

The goal of 140/90 mm Hg is now widely accepted and practised, which exposes large numbers of people to the adverse effects of hypertensive drugs without there being any proven benefit. Compared with the goal of 150/90 mm Hg, this target should be weighed up against the potential additional adverse effects and other risk factors affecting the patient.

©Prescrire September 2010

Source: "Chez les adultes hypertendus sans complication ni diabète : quelle pression artérielle viser ?" Rev Prescrire 2010 ; 30 (318): 315-316.