Cut systolic BP targets for heart failure risk patients

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

Previous studies have supported the introduction of 130/80mmHg targets for high-risk patients with diabetes or cardiovascular disease. However, there is little evidence to support current BP targets for hypertensive patients who do not have other conditions, the researchers said.

Paolo Verdecchia from Hospital Santa Maria della Misericordia in Italy and colleagues studied 1,111 non-diabetic patients who had systolic BPs of 150mmHg. 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% of patients assigned to the 130mmHg target and in 67% of patients assigned to the 140mmHg targets.

Patients in the two groups were similarly likely to receive antihypertensive 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% less likely to develop left ventricular hypertrophy and half as likely to experience other cardiovascular outcomes.

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

Lancet 2009;374;525-533.

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