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Best Outcomes Seen at Systolic BP of 130 to 139 mm Hg
Composite of mortality, end-stage renal disease increased at higher and lower blood pressures

MONDAY, Aug. 4, 2014 (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 Aug. 12 issue of the Journal of the American College of Cardiology.

John J. Sim, M.D., from the Kaiser Permanente Los Angeles Medical Center, and colleagues examined the ranges of treated blood pressure 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 percent of patients died and 1.2 percent developed end-stage renal disease. Compared with systolic blood pressure 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 blood pressure of 60 to 79 mm Hg. The lowest risk was seen for the nadir systolic and diastolic blood pressure of 137 and 71 mm Hg, respectively. The hazard ratio curve was similar for the population with diabetes mellitus, 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 authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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September 30, 2014

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