The Medical Letter on Drugs and Therapeutics
In Brief: New Hypertension Guidelines
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New US guidelines for the treatment of hypertension have recently been published.1

Probably the most important change from previous guidelines2 is that use of blood pressure-lowering medication is now recommended for secondary prevention in patients with cardiovascular disease and an average systolic blood pressure (SBP) ≥130 mm Hg or diastolic blood pressure (DBP) ≥80 mm Hg, and for primary prevention in adults with an estimated 10-year atherosclerotic cardiovascular disease (ASCVD) risk3 of ≥10% and an average SBP ≥130 mm Hg or DBP ≥80 mm Hg.

For patients with no history of cardiovascular disease and an estimated 10-year ASCVD risk of <10%, blood pressure-lowering medication is recommended for those with an average SBP ≥140 mm Hg or an average DBP ≥90 mm Hg.

A blood pressure target of <130/80 mm Hg is recommended for patients with markers for increased risk and may be reasonable, according to the new guideline, even for those with no markers for increased risk.

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