How high are blood pressure values? Heart specialists of the high pressure league answer

What is the maximum systolic blood pressure??
The experts argue: Where is the absolute limit of blood pressure? And when should drugs be used to lower high blood pressure? New studies indicate that a very early reduction in hypertension can prolong patients' lives.
While until recently there was widespread consensus among medical professionals that only a systolic blood pressure of more than 140 mmHg requires a blood pressure reduction, two recent studies conclude that lowering blood pressure to a maximum of 130 mmHg or even 120 mmHg has health benefits. However, this does not apply to all patients, reports the German High Pressure League e. V. (DHL).

Reducing systolic blood pressure to 120 mmHg can bring significant benefits to certain patients. (Image: Antonio Gravante / fotolia.com)

The new findings from the two major studies on hypertension lead to uncertainty among patients and doctors, according to DHL. For example, the SPRINT study suggests that lowering to an upper target value of 120 mmHg makes sense. However, this applies only to certain patients and the study results should not be generalized, warns DHL. The society advises hypertension patients to respond prudently to the new findings instead of changing the treatment in the short term. "Doctors should look at their patients individually to decide together with each one on the appropriate therapy," said the DHL statement.

Stronger blood pressure reduction recommended
Recent studies have reported that the meta-analysis of the George Institute for Global Health and the University of Oxford has included data from more than 600,000 patients from more than 120 studies on hypertension. This was published in the journal "The Lancet". The scientists wanted to find out to what extent a lower blood pressure can prevent cardiovascular diseases. According to their results, lowering the upper systolic value to less than 130 mmHg may be advisable, according to DHL's statement. Regardless of baseline, there were 27 percent fewer strokes and 13 percent fewer deaths when patients consistently lowered their blood pressure by 10 mmHg. The authors therefore advocated antihypertensive therapy in all patients with cardiovascular risk (increased risk of heart attack and stroke), diabetes and chronic kidney disease, well below the current limit of 140 mmHg.

120 mmHg as the target for the upper blood pressure?
The results of the SPRINT (Systolic Blood Pressure Intervention Trial) study indicate that even a maximum of 120 mmHg may be desirable for systolic blood pressure. The researchers looked for the appropriate target blood pressure for hypertensive patients with a high overall cardiovascular risk, explains the DHL. Diabetics had been excluded from the study. The comparison of two groups of patients - with blood pressure reduction to less than 120 mmHg and 134.6 mmHg - showed that 25 percent fewer patients died of stroke or myocardial infarction in the group with the medication-intensely lowered blood pressure.

Only certain patients affected
The new findings have sparked intense debate among experts about whether other target values ​​for high blood pressure patients need to apply. But Professor med. Martin Hausberg, CEO of the German High Pressure League, rejects this in the current press release. "The study results should not simply be transferred to all high-pressure patients," warns the expert. The blood pressure reduction below 120 mmHg applies only to certain patients, namely people with high cardiovascular risk, but without diabetes mellitus. Patients are also explicitly excluded after a stroke or during orthostatic hypotension (sudden sagging of blood pressure while standing).

Note the risk of side effects
Furthermore, according to Professor Hausberg, it should be noted that in the SPRINT study, more severe side effects occurred in the group with lowered blood pressure to 120 mmHg. These include, for example, acute renal failure and heart failure, according to the DHL statement. "If you lower the high blood pressure intensively, the patients must be closely monitored with regard to the side effects"; warns Prof. Hausberg. The current treatment guidelines of the European Society of Hypertension (ESH) foresee a target value for the upper blood pressure value of a maximum of 140 mmHg. The lower diastolic value should not exceed 90 mmHg. "A further reduction has not been considered advisable so far, as too low a reduction in the risk of cardiovascular diseases again slightly," says DHL. The new study results, however, speak for a significant reduction in blood pressure. "We have to wait and see if the results of both studies continue to be confirmed," explains Professor Hausberg. Also, the role of the drugs used for the success of the treatment is still unclear. However, it probably becomes necessary to adapt the treatment guidelines.

Despite the new findings, DHL advises for the time being to continue to treat all patients as "individual and with an eye on the whole person and not to reduce blood pressure more quickly." A greater reduction in blood pressure through intensification of the medical treatment also requires " close medical check an improved intersectoral cooperation ", so the conclusion of the high pressure league. (Fp)