New European blood pressure target for high cardiac risk patients

European guidelines regarding treatment of high blood pressure have been relaxed for people at high risk of cardiovascular disease, such as patients with diabetes.
Previous guidance recommended treating all high-risk patients to a target systolic blood pressure level of below 130 mmHg and healthy, low-risk individuals to target of less than 140/80.
But experts from the European Society of Cardiology and European Society of Hypertension have set new guidelines after deciding that latest evidence supports the introduction of a single, unified blood pressure target of below 130 mmHg for all people, regardless of their cardiovascular risk.
The experts examined the evidence from randomised controlled trials regarding clinical outcomes when blood pressure is lowered to below 130/80 mmHg compared with below 140/90 mmHg.
They found there was no consistent evidence that achieving systolic blood pressure levels below 130 mmHg cuts the risk of cardiovascular events, such as heart attack or stroke, compared with less than 140 mmHg in patients with diabetes or a history of cardiovascular or renal disease.
There was also no evidence to support lowering diastolic blood pressure to below 80 mmHg for this group of patients.
But the findings did show that reducing diastolic blood pressure below 85 mmHg is beneficial for diabetic patients, and the experts emphasise that diastolic levels of 80-85 mmHg are “safe and well tolerated” in all patients.
For older people up the age of 80, the evidence supports a target of 140–150 mmHg systolic blood pressure, or below 140 mmHg in particularly fit individuals. The 140–150 mmHg goal also applies to over-80s provided they are in good physical and mental health.
*UK blood pressure targets for people with diabetes remain at below 130/80. If you have diabetes, it may be a good idea to keep a close eye on the news over the next year to see if UK targets for diabetes patients change in line with the new European guidance.