Hypertension targets 'should be reduced' for all

A study of non-diabetic patients found 130mmHg target reduced cardiovascular events.

Systolic BP targets for patients with any risk factors for heart failure should be lowered to 130 mmHg, research published in The Lancet suggests.

Studies have supported the introduction of 130/80mmHg targets for high-risk patients with diabetes or cardiovascular disease. However, little evidence supports current BP targets for patients with hypertension who do not have other conditions, the researchers said.

Dr Paolo Verdecchia from Hospital Santa Maria della Misericordia in Italy and colleagues studied 1,111 non-diabetic patients who had systolic BPs of 150 mmHg. The researchers randomised patients to a systolic BP goal of under either 140mmHg or 130mmHg.

For two years they followed the patients and recorded the rate of left ventricular hypertrophy, which can lead to heart failure and heart rhythm problems.

The targets were achieved in 72 per cent of patients assigned to the 130mmHg target and in 67 per cent of patients assigned to the 140 mmHg target.

Patients in the two groups were similarly likely to receive anti-hypertensive drugs. However, patients in the 130mmHg group were more likely to be given diuretics and angiotensin-receptor blockers.

The researchers found that patients in the 130mmHg group were 37 per cent less likely to develop left ventricular hypertrophy and half as likely to experience other adverse cardiovascular outcomes.

Dr Verdecchia and his team said the findings lent support to the use of lower BP goals for all at-risk patients.

'Tight control of systolic BP to less than 130 mmHg in non-diabetic patients with at least one additional risk factor decreased the likelihood of electrocardiographic left ventricular hypertrophy and clinical events, compared with usual control, to less than 140mmHg systolic,' they commented.

'Because of the poor amount of BP control in the general population and clinical trials, and the direct relation between cardiovascular protection and BP lowering, the results of (our study) draw attention to the potential benefits of tight BP control in non-diabetic patients with hypertension,' they added.

However, the researchers stressed that further large-scale studies will be needed to confirm their findings.

tom.moberly@haymarket.com

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