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 ) .
"Strict" blood pressure control and progression of renal disease in hypertensive nephrosclerosis.
Hypertensive nephrosclerosis is a progressive renal disease and the leading cause of end-stage renal disease ( ESRD ) in blacks in the United States . It is generally believed that hypertensive renal injury is responsible for progressive renal failure ; however , it is not known whether pharmacologic lowering of blood pressure to any level prevents progression of renal disease . Accordingly , we performed a long-term prospect i ve r and omized trial to determine whether " strict " [ diastolic blood pressure ( DBP ) 65 to 80 mm Hg ] versus " conventional " ( DBP 85 to 95 mm Hg ) blood pressure control is associated with a slower rate of decline in glomerular filtration rate . Eighty-seven non-diabetic patients ( age 25 to 73 ; 68 black , 58 male ) with long-st and ing hypertension ( DBP > or = 95 mm Hg ) , chronic renal insufficiency ( GFR < or = 70 m/min/1.73 m2 ) and a normal urine sediment were studied . DBP was pharmacologically lowered to < or = 80 mm Hg ( 3 of 4 consecutive measurements at 1 to 4 weeks intervals ) after which patients were r and omized . DBP and GFR ( renal clearance of 125I-iothalamate ) were measured at baseline , at three months and every six months post-r and omization . The rate of decline in GFR ( GFR slope , in ml/min/1.73 m2/year ) , estimated by the method of maximum likelihood in a mixed effects model , was the primary outcome variable . In a secondary analysis , 50 % reduction in GFR ( or a doubling of serum creatinine ) from baseline , ESRD and death were combined . ( ABSTRACT TRUNCATED AT 250 WORDS
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 ) .