Hypertension, diabetes, obesity. What are the goals of blood pressure treatment? 3
What is the best blood pressure control in hypertension? 140/90? 130/80? It matters because higher doses or additional medications might be required to achieve different blood pressure goals. Does diabetes or obesity matter in setting blood pressure control goal? How much risk of a heart attack or stroke is reduced by lower blood pressure goals? Leading hypertension expert. You’ve done a lot of research on the blood pressure goals for hypertension treatment in patients with diabetes, obesity, and hypertension. Dr. Anton Titov, MD. What is different with treatment goals in hypertension in a patient with obesity? Dr. Ehud Grossman, MD. It’s very interesting. Because if you would have asked me three years ago, I would say that in diabetic patients you have to go to 130 / 80 blood pressure goals. But for general population the blood pressure treatment goals are 140 / 90. It is good enough. Now that we have the SPRINT clinical trial. This clinical trial was done in non-diabetic subjects. They showed clearly that 120 / 80 is much better than 140 / 90. That’s why the American Heart Association suggests blood pressure therapy goal of 130 / 80. They also define now hypertension differently. If you have blood pressures above 130 over 80, you are hypertensive. Dr. Ehud Grossman, MD. So in the past there was a clear difference between the target of blood pressure treatment in diabetic and non-diabetic patients. In diabetic patients with hypertension we wanted blood pressure 130 over 80. In non-diabetic hypertension we targeted 140 over 90. Nowadays it’s the same goal. Dr. Ehud Grossman, MD. Now you have to go to the same blood pressure goal in diabetics and non diabetics. This should be less than 130 or at least close to 130 / 80. Dr. Anton Titov, MD. In diabetic patients you see definitely much lower events rate [stroke, heart attack] when you lower the blood pressure to 130 over 80.
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