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German high pressure league reviews new blood pressure target values in the USA
American specialist societies already classify blood pressure values of 130 to 139 mmHg systolic and 80 to 89 mmHg diastolic as hypertension grade 1. The German Hypertension League (DHL®) will carefully review the new recommendations, but advocates setting moderate goals for lowering blood pressure.
A basic idea of the new American guideline is that patients diagnosed with high blood pressure will adapt their lifestyle early on in order to normalize their blood pressure values or, if this is not possible, can be treated with medication. In Germany, however, the new recommendations are still being awaited or viewed critically.
In Germany, 20-30 million people are affected by high blood pressure. The currently valid definition of high blood pressure is so far the existence of a systolic blood pressure of 140 mmHg or higher and / or a diastolic blood pressure value of 90 mmHg or higher.
It has been known for decades that the risk of cardiovascular diseases in the general population increases significantly from blood pressure values of over 115/75 mmHg, which means that the risk of getting sick also exists in the highly normal blood pressure range. Therefore, determining the target values for lowering blood pressure should always be a matter of judgment. Based on the current study situation, the German Hypertension League currently recommends lowering blood pressure to below 140/90 mmHg and below 135/85 mmHg for cardiovascular (high) risk patients.
“Lowering the blood pressure limit to below 130/80 mmHg, as has now been proposed in the United States, would sensitize those affected and doctors to the moderately increased risk of cardiovascular diseases that already exists with these blood pressure values. This could encourage earlier lifestyle changes such as weight loss, low-salt diet, healthy eating and sufficient exercise, ”says Professor Dr. med. Bernhard Krämer, DHL® CEO.
“On the other hand, significantly lower people than before are classified as patients by lowering the blood pressure limits. So far, however, there is no evidence that lowering drug blood pressure has positive effects for most people with highly normal blood pressure values. Of course, even with high-normal blood pressure, lifestyle changes can be made without having to classify the patient as a high-pressure patient, ”adds the CEO.
The German Hypertension League and the European Hypertension Specialists will now include the current proposals from the United States in their considerations to revise their guidelines.
"However, due to the expanded data base according to SPRINT and related publications and meta-analyzes, we still recommend a general target value of less than 135/85 mmHg for a self-measurement," says Professor Dr. Peter Trenkwalder, Deputy DHL® CEO and member of the DHL® Scientific Opinions and Guidelines Task Force. In Germany, the moderate target blood pressure is currently being reached in less than 60 percent of the patients. "The most important treatment goal for all doctors must therefore be that this blood pressure target is reached," says the expert.