Lowering the systolic blood pressure target in hypertensive patients: current controversies and future outlook

ABSTRACT

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.

KEYWORDS:

• Optimal blood pressure target
• international guidelines
• optimal evaluation of blood pressure levels
• adverse effect of intensive blood pressure lowering therapy
• controversies
• future outlook

Declaration of interest

K. Kario received research funding from Teijin Pharma Limited, Omron Healthcare Co., Fukuda Denshi, Bayer Yakuhin Ltd., A &D Co., Daiichi Sankyo Co., Mochida Pharmaceutical Co., EA Pharma, Boehringer Ingelheim Japan Inc., Tanabe Mitsubishi Pharma Corporation, Shionogi & Co., MSD K.K., Sanwa Kagaku Kenkyusho Co., and Bristol-Myers Squibb K.K.; and honoraria from Takeda Pharmaceutical Co. and Omron Healthcare Co. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Additional information

Funding

This paper was not funded.