Best Outcomes with Systolic BP of 130-139 mm Hg

Composite of mortality, end-stage renal disease increased at higher and lower BP.
Composite of mortality, end-stage renal disease increased at higher and lower BP.

For patients with treated hypertension, worse outcomes are seen for those with systolic and diastolic blood pressures lower and higher than 130-139 mm Hg and 60-79 mm Hg, respectively, according to a study published in the Journal of the American College of Cardiology (2014;64:588-597).

John J. Sim, MD, from the Kaiser Permanente Los Angeles Medical Center, and colleagues examined the ranges of treated blood pressure in a large population of patients with hypertension. Data were collected for 398,419 patients with hypertension, aged 18 years or older, who were receiving treatment.

The researchers found that 6.3% of patients died and 1.2% developed end-stage renal disease (ESRD). Compared with a systolic blood pressure (SBP) of 130 to 139 mm Hg, an SBP less than 110 mm Hg, 110-119 mm Hg, 120-129 mm Hg, 140-149 mm Hg, 150-159 mm Hg, 160-169 mm Hg, and 170 mm Hg or higher was associated with a 1.8, 1.1, 1.4, 2.3, 3.3, and 4.9 times increased risk of a composite endpoint of mortality and ESRD, respectively.

The lowest risk was associated with diastolic blood pressure of 60-79 mm Hg. The lowest risk was seen for the nadir systolic and diastolic blood pressure of 137 and 71 mm Hg, respectively.

"Our study adds to the growing uncertainty about blood pressure treatment targets," the authors wrote.

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