140/90 May Be Enough

Heartwire just published an interesting article that says lower blood pressures goals may not beneficial.   Blood pressure targets have tended to trend downward over the past few years, and this article flies in the face of that.

We found there is no evidence that reaching a target of below 90 mm Hg diastolic BP will provide additional clinical benefit, but we can’t say whether lowering systolic BP below 140 mm Hg will be beneficial or not; there are no data

Arguedas and his colleagues note that a lower BP target of 130/80 mm Hg is currently recommended for at-risk patients, and they did perform a sensitivity analysis in diabetic and kidney-disease patients, which did not show significant benefits for treating to targets of lower than 135/85 mm Hg. “However, in these two populations, the evidence for a lack of benefit is less robust,” they note.

It’s long been known that people with naturally lower blood pressure tend to do better than those with artificially lower blood pressure, but we still think lower is better.  That can lead to adverse effects, including lowering BP too low (that’s discussed in the article) and putting patients on too complicated, and expensive, a blood pressure regimin.