Intensive Blood Pressure Management
Intensive management targets a systolic blood pressure ≤120 mmHg and may be considered in high-risk patients who are ≥50 years old, have systolic blood pressure ≥130 mmHg and have any of the following:
- Clinical or subclinical cardiovascular disease
- Chronic kidney disease (nondiabetic nephropathy, proteinuria <1 g/d, eGFR 20-59 mL/min/1.73 m2)
- Framingham risk score ≥15%
- Age ≥75 years
This approach is based on The Systolic Blood Pressure Intervention Trial (SPRINT).
During SPRINT, patients treated intensively (<120 mmHg), instead of routinely (<140 mmHg), had a 25% lower relative risk of major cardiovascular events and death and a 27% lower relative risk of death from any cause.
Patients who may not be suitable for intensive management include those with:
- Secondary hypertension
- Diabetes
- Recent heart attack (within 3 months)
- History of stroke
- Heart failure (reduced left ventricular ejection fraction <35%)
- Kidney disease (eGFR <20)
- Standing SBP <110 mmHg following one minute of standing
- Frail or institutionalized elderly
Trackbacks & Pingbacks