Treating patients to lower than st and ard BP targets , < /=140 - 160/90 - 100 mmHg , does not reduce mortality or morbidity .
BACKGROUND When treating elevated blood pressure , doctors need to know what blood pressure ( BP ) target they should try to achieve .
The st and ard of clinical practice for some time has been < /= 140 - 160/ 90 - 100 mmHg .
New guidelines are recommending BP targets lower than this st and ard .
It is not known whether attempting to achieve targets lower than the st and ard reduces mortality and morbidity .
OBJECTIVES To determine if lower BP targets ( < /= 135/85 mmHg ) are associated with reduction in mortality and morbidity as compared with st and ard BP targets ( < /= 140 - 160/ 90 - 100 mmHg ) .
A decrease in diastolic blood pressure combined with an increase in systolic blood pressure is associated with a higher cardiovascular mortality in men.
OBJECTIVES The study evaluated the risk of cardiovascular mortality according to combined spontaneous ( non-treatment-related ) changes in both systolic and diastolic blood pressure ( BP ) . BACKGROUND Long-term longitudinal changes in blood pressure may be a more accurate determinant of cardiovascular risk since changes in systolic or diastolic blood pressure over a period of time reflect the evolution of arterial and arteriolar alterations . METHODS Two independent French male cohorts were studied : the IPC cohort ( Investigations Préventives et Cliniques ) composed of 15,561 men aged 20 to 82 years who had had two visits spaced four to 10 years apart , and the Paris Prospect i ve Study composed of 6,246 men aged 42 to 53 years , examined annually for a period of four years . None of the subjects were taking antihypertensive medication . Annual changes in BP were estimated , and subjects were divided into groups according to the increase , lack of change , or decrease of systolic or diastolic BP . Nine groups were formed by combining the changes of systolic and diastolic BP . Cardiovascular mortality was assessed for a mean period of 13.5 years for the IPC Study and 17 years for the Paris Prospect i ve Study . RESULTS In both cohorts , after adjustment for age and major risk factors , the group with an increase in systolic and a decrease in diastolic BP presented the highest relative risk of cardiovascular mortality compared to the group with no changes in either systolic or diastolic BP ( relative risk : 2.07 [ 1.05 to 4.06 ] in the IPC Study and 2.16 [ 1.16 to 4.01 ] in the Paris Prospect i ve Study ) . CONCLUSIONS Assessment of spontaneous changes of BP over a long period of time can contribute to the evaluation of cardiovascular risk . Subjects whose systolic BP increased while their diastolic BP decreased had the highest cardiovascular risk independently of absolute values of BP or other risk factors
Treating patients to lower than st and ard BP targets , < /=140 - 160/90 - 100 mmHg , does not reduce mortality or morbidity .
BACKGROUND When treating elevated blood pressure , doctors need to know what blood pressure ( BP ) target they should try to achieve .
The st and ard of clinical practice for some time has been < /= 140 - 160/ 90 - 100 mmHg .
New guidelines are recommending BP targets lower than this st and ard .
It is not known whether attempting to achieve targets lower than the st and ard reduces mortality and morbidity .
OBJECTIVES To determine if lower BP targets ( < /= 135/85 mmHg ) are associated with reduction in mortality and morbidity as compared with st and ard BP targets ( < /= 140 - 160/ 90 - 100 mmHg ) .