Blood Pressure: New Evidence New Targets

Abstract

Raised blood pressure, along with smoking and raised cholesterol levels, is a key modifiable risk factor for cardiovascular (CV) disease in people with diabetes. “Hypertension” is in fact not a clinical disease in itself, in that individuals with raised blood pressure do not generally have symptoms, but rather have a risk factor for CV disease. There is no discrete boundary that defines the hypertensive state from the non-hypertensive one, and judgment is required to determine the diagnostic threshold (if one is used) and to determine target BP levels for treatment. Clinical guidelines have progressively lowered the threshold for diagnosing “hypertension” in both people with and without diabetes, from the 1970s definition of having a systolic blood pressure (SBP) of 160mmHg or diastolic blood pressure (DBP) of 95mmHg, to a SBP of 140mmHg or DBP of 90mmHg.