[Blood pressure target in 2017].

Area of Science:

• Cardiology
• Hypertension Management
• Preventive Medicine

Background:

• Current hypertension guidelines recommend systolic blood pressure (BP) targets between 130-139 mmHg.
• Recent studies, like SPRINT, suggest lower targets (<120 mmHg) may reduce cardiovascular (CV) events but increase risks.
• Debate continues regarding optimal BP targets in clinical practice.

Purpose of the Study:

• To review the clinical relevance of individualized blood pressure (BP) goals in hypertensive patients.
• To consider age, comorbidities, and established cardiovascular disease in setting BP targets.
• To analyze the implications of different BP measurement methods and intensive treatment approaches.

Main Methods:

• Literature review of current hypertension guidelines and clinical trial data (e.g., SPRINT).
• Analysis of factors influencing BP treatment targets, including measurement techniques and patient characteristics.
• Consideration of the J-curve phenomenon in relation to BP and CV events.

Main Results:

• Lowering systolic BP to <120 mmHg may significantly reduce CV morbidity and mortality.
• Differences in BP measurement methods (e.g., Dinamap vs. routine practice) impact treatment targets.
• Intensive BP control may be associated with increased iatrogenic risk and requires careful monitoring.

Conclusions:

• Early and strict BP control is a priority for young to middle-aged hypertensive patients in primary prevention.
• More stringent BP lowering may prevent long-term hypertensive damage and reduce residual CV risk.
• Tolerance of intensive BP treatment requires careful consideration in elderly patients and those with established CV disease.