New blood pressure target values?
So far, a target blood pressure of less than 140/90 mmHg - according to the motto "one fits all". Now, the German High Pressure League e.V. DHL® has revised this recommendation as a result of the SPRINT study: With cardiovascular risk patients, a blood pressure target of less than 135/85 mmHg should now be aimed at. For the others, the previous target area remains.
The German Hypertension League e.V. DHL® - German Society for Hypertension and Prevention holds onto moderate target values almost two years after the publication of the American SPRINT study due to the current data situation and emphasizes the need for exact measurements.
The background: In 2015, the American SPRINT study showed that an intensive lowering of blood pressure to an upper systolic target value of less than 120 mmHg better protects people with high blood pressure from heart attack, stroke, heart failure and cardiovascular death than the previously preferred target value of less than 140 mmHg. However, these study results only apply to certain patients: people with a high cardiovascular risk but without diabetes mellitus.
Specialist societies in Canada, Australia and Austria as well as the ISH (International Society of Hypertension) have recommended a more intensive reduction in blood pressure since the publication of the SPRINT data. DHL® did not fully follow these recommendations in its current statement. Due to the expanded data situation according to SPRINT as well as related publications and meta-analyzes, DHL® continues to recommend a general target value of less than 140/90 mmHg. The most important treatment goal for all doctors must be that this blood pressure goal is reached.
Only in cardiovascular risk patients analogous to SPRINT should a value of less than 135/85 mmHg be striven for, according to the "Recommendations 2017". This applies to patients with previous cardiovascular diseases other than stroke, aged 75 years or older, with chronic kidney disease CKD 3 and a high vascular risk (≥ 15 percent according to the Framingham Risk Score).
The current opinion of the German Hypertension League also deals with blood pressure measurement. An unconventional type of blood pressure measurement - the automated practice blood pressure measurement - was used in the SPRINT study. It was used to measure values in the SPRINT study that, according to DHL®, cannot be compared one to one with conventionally measured values. The "Recommendations 2017" of the German Hypertension League refer to conventional blood pressure measurement in practice.