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February 14, 2017

Hypertension in 2017—What Is the Right Target?

Author Affiliations
  • 1Boston University Medical Center, Boston, Massachusetts
JAMA. 2017;317(6):579-580. doi:10.1001/jama.2017.0105

Setting blood pressure (BP) goals is not an exact science. Such goals have generally relied on findings from clinical trials that typically have differed in such important variables as age of participants, entry and exclusion criteria, presence or absence of concomitant illnesses, severity of hypertension, treatment regimens, and therapeutic goals. Furthermore, few previous trials have been designed to compare the effects of lowering BP to different targets.

Controversy exists currently on BP goals. For several years following publication of the JNC 7 report,1 there appeared to be consensus regarding a goal BP of less than 140/90 mm Hg for most persons with hypertension, irrespective of age, and levels of less than 130/80 mm Hg for those with diabetes, chronic renal diseases, and certain cardiovascular conditions. However, 3 major groups have since made new and differing recommendations regarding BP goals, particularly in older persons, and the results of new trials have become available. The JNC 8 committee raised the systolic BP (SBP) goal for those aged 60 years or older to less than 150 mm Hg.2 The European Society of Hypertension/European Society of Cardiology joint committee advocated a goal of less than 140 to 150 mm Hg for those aged 80 years or older.3 A joint committee representing the American Society of Hypertension and the International Society of Hypertension recommended a target of less than 150/90 mm Hg for those aged 80 years or older.4

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