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Treating hypertension: How low should blood pressure be with medication?

In this 2-minute video, Dr. Richard Sztramko discusses what blood pressure targets should be for those being treated with medications for hypertension and some of the considerations that impact those targets, such as orthostatic hypotension.

 

 

What's the bottom line?

  • The decision to treat high blood pressure and the target for treatment should always involve a discussion between the patient and their primary care provider and be based on the patient's values and the best scientific evidence.
  • Generally, a target of less than 140/90 is recommended for those with a diagnosis of hypertension, but there is some evidence to suggest a lower target, and in some cases, even below 120/80. In these cases, patient values and side effects from the medications should be considered.
  • Orthostatic hypotension, or the falling of blood pressure when you stand, is an important consideration, especially due to the risk of falls.
  • Other medical conditions, such as diabetes and Parkinson's disease, can contribute to orthostatic hypertension, and in such cases, a higher baseline blood pressure may be warranted.

 

Watch the full-length video to learn about when treatment with medications is warranted and the kinds of medications that are available.

 

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References

  1. ÆßÃõ¼º½ Optimal Aging Portal. Studies support “risk-based” approach to treating people with high blood pressure. (2015 Mar). Accessed August 11, 2021. Available from : /blog/detail/blog/2015/03/18/studies-support-risk-based-approach-to-treating-people-with-high-blood-pressure
  2. Robitaille C, Dai S, Waters C et al. Diagnosed hypertension in Canada: incidence, prevalence and associated mortality. CMAJ. 2012; 184(1):E49-E56.
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  7. Blood Pressure Lowering Treatment Trialists' Collaboration. Pharmacological blood pressure lowering for primary and secondary prevention of cardiovascular disease across different levels of blood pressure: an individual participant-level data meta-analysis. Lancet. 2021 May 1;397(10285):1625-1636. doi:10.1016/S0140-6736(21)00590-0
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Acknowledgements

This work was supported through the ÆßÃõ¼º½ Institute for Research on Aging and funds provided by the Dean and Vice-President, Faculty of Health Sciences at ÆßÃõ¼º½. 

DISCLAIMER: These summaries are provided for informational purposes only. They are not a substitute for advice from your own health care professional. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the ÆßÃõ¼º½ Optimal Aging Portal (info@mcmasteroptimalaging.org).

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