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For most people, recommendations are to reduce blood pressure to less than or equal to somewhere between 140/90 mmHg and 160/100 mmHg. [2] In general, for people with elevated blood pressure, attempting to achieve lower levels of blood pressure than the recommended 140/90 mmHg will create more harm than benefits, [3] in particular for older people. [4]
Goal blood pressure (mmHg) Initial treatment options ESC 2024 [2] General 120–129/70–79 BP >140/90: Two from different classes: preferably RAS-inhibitor (ACEI or ARB) with either thiazide diuretic/thiazide-like diuretic or dihydropyridine CCB. ESH 2023 [3] General age <65 General age 65–79 General age ≥80 <130/80 <140 SBP <150 SBP
In the United States, the JNC8 (Eighth Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure) recommends thiazide-type diuretics to be one of the first-line drug treatments for hypertension, either as monotherapy or in combination with calcium channel blockers, ACEis, or ARBs. [7]
[7] [12] [13] HYVET study showed that indapamide (sustained release), with or without perindopril as antihypertensive treatment in persons 80 years of age or older with sustained systolic blood pressure of 160 mmHg or higher, demonstrated significant reduction in all-cause mortality when treated to a target of 150/80 mmHg, but there was found ...
"Your blood pressure is supposed to be under 140 over 90, optimally closer to 120 over 80."
The treatment of moderately high arterial blood pressure (defined as >160/100 mmHg) with medications is associated with an improved life expectancy. [15] The effect of treatment of blood pressure between 130/80 mmHg and 160/100 mmHg is less clear, with some reviews finding benefit [6] [16] [17] and others finding unclear benefit.
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