Intensive blood pressure lowering: a practical review

• Published in: Clinical hypertension Vol. 26; no. 1; pp. 1 - 8
• Main Authors: Camafort, Miguel, Redón, Josep, Pyun, Wook Bum, Coca, Antonio
• Format: Journal Article
• Language: English
• Published: London BioMed Central Ltd 01.11.2020; BioMed Central; BMC; 대한고혈압학회
• Subjects: Age; Ageing; Analysis; Antihypertensives; Blood pressure; Blood pressure measurement; Body mass index; Cardiovascular disease; Chronic kidney disease; Chronic kidney failure; Comorbidity; Diabetes; Diabetes mellitus; Diabetes mellitus type 2; Disease; Frailty; Health aspects; Heart diseases; Heart failure; Hypertension; Intensive blood pressure lowering; Ischemia; Ischemic heart disease; Kidney diseases; Mortality; Obesity; Obesity, cardiovascular risk; Older people; Population; Pressure measurement; Review; South Korea; 내과학; South Korea
• ISSN: 2056-5909; 1342-2154; 2635-6325; 2056-5909
• DOI: 10.1186/s40885-020-00153-z

According to the last Hypertension guideline recommendations, it may be concluded that intensive BP lowering is only advisable in a subgroup of patients where there is a clear net benefit of targeting to lower BP goals. However, taking into account the relevance of correct BP measurement, estimates of the benefits versus the harm should be based on reliable office BP measurements and home BP measurements. There is still debate about which BP goals are optimal in reducing morbidity and mortality in uncomplicated hypertensives and in those with associated comorbidities. In recent years, trials and meta-analyses have assessed intensive BP lowering, with some success. However, a careful examination of the results shows that current data are not easily applicable to the general hypertensive population. This article reviews the evidence on and controversies about intensive BP lowering in general and in specific clinical situations, and the importance of obtaining reliable BP readings in patients with hypertension and comorbidities.