Treatment goals for patients with hypertension

  The goal of treatment for patients with hypertension is to reduce the overall risk of cardiovascular morbidity and mortality, which is an important aspect in the prevention and treatment of cardiovascular diseases. According to the available evidence the goals of blood pressure reduction are: 1. Blood pressure (both systolic and diastolic) in patients with common hypertension should be strictly controlled to below 140/90 mmHg.  2, Patients with coronary artery disease should be reduced to below 130/85mmHg.  3.Patients with diabetes mellitus and renal disease should be lowered to below 130/80mmHg, and the antihypertensive treatment for diabetic patients should start from >130/80mmHg.  4.Diabetes mellitus with ischemic heart disease, blood pressure should be lowered to below 120/80mmHg.  In elderly people, systolic blood pressure should be lowered to below 150mmHg and can be further lowered if tolerated; when diastolic blood pressure is <70mmHg in elderly people, attention should be paid to any manifestation of organ perfusion deficiency, such as weakness, vertigo, drowsiness, transient ischemic attack, etc.  For unilateral carotid stenosis >70%, systolic pressure should not be lower than 130mmHg; for bilateral carotid stenosis >70%, systolic pressure should not be lower than 150mmHg, otherwise there is an increased risk of cerebral ischemia.  Antihypertensive treatment strives to achieve the above criteria. New patients generally respond quickly to drugs, while older patients take weeks to months. Modern antihypertensive drugs are slow to work and often take 4-5 weeks to really peak. Treatment should be individualized, observed for response, and made as low as possible as tolerated by the patient, as blood pressure above 115/70 mmHg already begins to damage the heart and brain vessels.