Blood pressure treatment targets

Blood pressure (BP) treatment targets vary among Australian and international guidelines.

Generally, for patients who require BP-lowering therapy, the aim is to reduce BP to below 140/90 mmHgArguedas, 2020.

In patients with high atherosclerotic cardiovascular disease (ASCVD) risk, lowering BP to below 130/80 mmHg reduces cardiovascular morbidity and may reduce mortalityWilliams, 2018Zhang, 2021. However, these benefits may not extend to patients older than 80 yearsZhang, 2021.

Although there is trial evidence that a lower target of 120/80 mmHg is beneficial in patients with high ASCVD risk, the method of BP measurement in the trial did not reflect real-world practiceDrawz, 2020Sprint Research Group, 2021. Aiming for a BP below 120 mmHg may be reasonable provided the risk of adverse effects is low (eg risk of falls). Monitor for hypotension, syncope, electrolyte abnormalities and worsening kidney function.

BP treatment targets may be difficult to achieve in some patients, even with combination drug therapy. However, movement towards the target BP, even if it is not reached, is likely to reduce ASCVD risk.