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Should the target for blood pressure control specify both a systolic and a diastolic component?
Christopher J Hebert1, Ganesh Shidham, Lee A Hebert
1Cleveland Clinic Foundation, 9500 Euclid Avenue, Mail Drop S70, Cleveland, OH 44195, USA. hebertc@ccf.org
Abstract:
The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) Report recommends, as the target for hypertension control, achieving both a systolic and diastolic goal. We suggest, however, that specifying both a systolic and a diastolic component for the blood pressure goal can be confusing to physician and patient. Furthermore, literal interpretation and application of this JNC 7 recommendation could result in overtreatment, undertreatment, or institution of treatment for hypertension when none is needed. Specific scenarios illustrating how inappropriate treatment could result from literal interpretation and application of the JNC 7 recommendations are presented. Our recommended blood pressure goal for hypertensives is: Sitting systolic blood pressure consistently in the 120s or less, if tolerated. This recommendation is evidence based, easy to understand, and achievable. Its rationale is discussed.
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The average BP in an adult is typically around 120/80 mmHg (millimeters of mercury). In this measurement, the numerator (120) indicates the systolic pressure, which is the pressure in the arteries during the contraction of the heart's ventricles as blood is expelled. The denominator (80) represents the diastolic...
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