BP targets unachievable in most patients
Current blood pressure targets are unachievable in most patients, primary care specialists say. They suggest that it is more important to find out what patients want from treatment than to strive to achieve the targets.
Writing in the BMJ (2004;329:
523), Neil Campbell and Peter Murchie, from the department of general
practice and primary care, University of Aberdeen, comment on the two
new hypertension guidelines issued this year by the National
Institute for Clinical Excellence and the British
Hypertension Society.
They say that although there is plenty of evidence of the benefits of
lowering blood pressure, treatment targets are less evidence based. Further,
to reach current targets (systolic blood pressure of 140mm Hg [or 130mm
Hg, eg, in diabetics]), most patients will require up to four drugs. “Some
[patients] will judge blood pressure lowering as vital and will tolerate
inconvenience and discomfort to achieve a lowered cardiovascular risk.
Others will not and we should accept this.”
They conclude: “Appropriate management of blood pressure should
therefore be guided by an informed dialogue between patients and doctors
and not by blind pursuit of blood pressure targets.” |
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