Key result
Intensive BP control below 130/80 mmHg remains globally controversial despite AHA/ACC guidelines.
Why the study?
Does intensive blood pressure lowering (target 130/80 mmHg) improve outcomes compared to standard targets in hypertensive patients?
Does intensive blood pressure lowering (target 130/80 mmHg) improve outcomes compared to standard targets in hypertensive patients?
This review summarizes the evidence and ongoing controversies surrounding the 2017 AHA/ACC guidelines recommending a lower blood pressure target of 130/80 mmHg.
Ongoing controversy warrants caution against universal <130/80 mmHg adoption; leaves open optimal global targets for prospective trials.
INTRODUCTION: Randomized controlled trials and meta-analyses have established the benefits of blood pressure (BP) lowering. The 2017 American Heart Association/American College of Cardiology (AHA/ACC) guidelines for the management of hypertension established 130/80 mmHg as the threshold for the diagnosis- and treatment-target BP level. Area covered: The global trends are thought to be heading toward intensive BP-lowering management. In this paper, authors summarize the evidence on lowering the BP target in hypertensive patients with a focus on the 2017 AHA/ACC guidelines. Expert commentary: According to the results of clinical research, meta-analyses and the 2017 AHA/ACC guidelines, the target systolic BP may change from less than 140/80 mmHg to 130/80 mmHg in any other international hypertension guidelines. However, this direction of intensive BP control is still controversial.
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Narita et al. (2018) conducted a review in Hypertension. Intensive blood pressure lowering (target <130/80 mmHg) vs. Standard blood pressure control (target <140/80 mmHg) was evaluated. Intensive blood pressure control targeting <130/80 mmHg is recommended by the 2017 AHA/ACC guidelines, though adopting this lower target remains controversial globally.
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