Bloeddrukstreefwaarden bij hypertensiebehandeling

Conflict of interest and financial support: disclosure forms provided by the authors are available along with the full text of this article at www.ntvg.nl; search for A5638, click on ‘Belangenverstrengeling’ (‘Conflict of interest’).

• A relationship between blood pressure level and cardiovascular morbidity and mortality can be demonstrated by way of a J-curve.The curve’s lowest point, the optimal blood pressure, does not appear to be the same for all patients.

• The target blood pressure values found in guidelines are partly based on randomised interventional studies in which different target values have been compared.

• The general advised target blood pressure is < 140/90 mmHg for patients with cardiovascular disease or chronic kidney disease. For patients with diabetes mellitus the target blood pressure is < 140/85 mmHg.

• It has been proven that blood pressure-lowering agents are effective for patients above 80 years who are hypertensive; the target values in these patients are SBP: 140-150 mmHg and DBP: 70-80 mmHg.Lowering the blood pressure in the fragile elderly should be carried out with caution.

• In patients with coronary heart disease or diabetes mellitus, the optimal blood pressure for preventing a stroke could be lower than for preventing a myocardial infarction.