Study Examines Optimal BP Treatment Targets

(HealthDay News) — For patients with treated hypertension, worse outcomes are seen for those with systolic and diastolic blood pressures lower and higher than 130 to 139 mm Hg and 60 to 79 mm Hg, respectively, according to a study published in the Journal of the American College of Cardiology.

John J. Sim, MD, from the Kaiser Permanente Los Angeles Medical Center, and colleagues examined the ranges of treated blood pressure (BP) in a large population of patients with hypertension. Data were collected for 398,419 patients with hypertension, aged 18 years or older, who were receiving treatment.

The researchers found that 6.3% of patients died and 1.2% developed end-stage renal disease. Compared with systolic BP of 130 to 139 mm Hg, the adjusted hazard ratios for composite mortality/end-stage renal disease were 4.1 for <110 mm Hg; 1.8 for 110 to 119 mm Hg; 1.1 for 120 to 129 mm Hg; 1.4 for 140 to 149 mm Hg; 2.3 for 150 to 159 mm Hg; 3.3 for 160 to 169 mm Hg; and 4.9 for ≥170 mm Hg. 

The lowest risk was associated with diastolic BP of 60 to 79 mm Hg. The lowest risk was seen for the nadir systolic and diastolic BP of 137 and 71 mm Hg, respectively. The hazard ratio curve was similar for the population with diabetes, with a lower nadir at 131 and 69 mm Hg, respectively. A higher nadir was seen for those age ≥70 years (140 and 70 mm Hg, respectively).

“Our study adds to the growing uncertainty about blood pressure treatment targets,” the researchers wrote.

Several authors disclosed financial ties to the pharmaceutical industry.


  1. Sim JJ et al. J Am Coll Cardiol. 2014;64(6):588-597.