Evidence Builds For Risk-based Antihypertension Guidelines
Key clinical point: Many people with systolic blood pressures of 120-139 mm Hg have significant cardiovascular disease risk that often goes untreated.
Major finding: People with a systolic blood pressure of 120-139 mm Hg generated 45% of excess cardiovascular disease events.
Data source: Analysis of 10-year outcomes of 18,898 American adults followed in either the ARIC study or in the Framingham Offspring Study.
Disclosures: Dr. Karmali and Dr. Lloyd-Jones had no disclosures.
AT THE AHA SCIENTIFIC SESSIONS
He acknowledged the need for some caution in this approach, such as recognizing that blood pressure must be carefully reduced in, for example, people with a systolic pressure of 120-129 mm Hg so that blood pressure is not reduced to a dangerously low level (unlike cholesterol, which so far has not shown been shown to cause problems when reduced to very low levels). He also noted that a young adult with a fairly high systolic pressure of, say, 160 mm Hg should receive antihypertensive treatment even if the person has an otherwise low ASCVD risk. But in general a risk-based approach should provide better patient care, he said.
“If this is where new hypertension management guidelines go it would be a significant change,” Dr. Lloyd-Jones acknowledged, “but I think it would help patients. I think this approach merits real consideration” by the panel that will soon create the next revision to the U.S. hypertension management guideline.
