Journal of Hypertension: Open Access

Optimal Blood Pressure Goals in Patients with Hypertension at High Risk for Cardiovascular Events

Abstract

Wilbert S Aronow

The 2013 European Society of Hypertension guidelines recommended that lowering the blood pressure to less than 130/80 mmHg in patients with hypertension at high risk for cardiovascular events was unsupported by prospective trial data, and that the systolic Blood Pressure (BP) should be decreased to less than 140 mmHg in these patients and the systolic BP reduced to between 140 to 150 mmHg in patients aged 80 years and older with an initial systolic BP of 160 mmHg or higher provided they are in good physical and mental condition. The American College of Cardiology Foundation/American Heart Association 2011 expert consensus document on hypertension in the elderly recommended that the BP should be lowered to less than 140/90 mmHg in adults with hypertension younger than 80 years at high risk for cardiovascular events. On the basis of data from the Hypertension in the Very Elderly trial, these guidelines recommended that the systolic BP should be reduced to 140 to 145 mmHg if tolerated in adults aged 80 years and older. This article discusses the clinical trial data supporting these guidelines in patients at high risk for cardiovascular events because of coronary artery disease, diabetes mellitus, chronic kidney disease, and heart failure.