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Blood Pressure Management
5.2.7. Blood Pressure Goal for Patients With Hypertension
COR LOE
Recommendations
1 A
1. In adults with confirmed hypertension who are at increased
risk* for CVD, an SBP goal of at least <130 mm Hg, with
encouragement to achieve SBP <120 mm Hg, is recommended
to reduce the risk of cardiovascular events and total mortality.
2b B-NR
2. In adults with confirmed hypertension who are not at
increased risk* for CVD, an SBP goal of <130 mm Hg,
with encouragement to achieve SBP <120 mm Hg, may be
reasonable to reduce risk of further elevation of BP.
1 B-R
3. In adults with confirmed hypertension who are at increased
risk* for CVD, a DBP target of <80 mm Hg is recommended
to reduce the risk of cardiovascular events and total mortality.
2b B-NR
4. In adults with confirmed hypertension who are not at
increased risk* for CVD, a DBP target of <80 mm Hg may be
reasonable to reduce the risk of cardiovascular events.
* Increased risk is defined as a 10-year predicted risk for CVD events of ≥7.5% using PREVENT.
5.3.1. Diabetes
COR LOE
Recommendations
1 A
1. In adults with T2D and hypertension, antihypertensive drug
treatment should be initiated at an SBP of ≥130 mm Hg with a
treatment goal of <130 mm Hg, with encouragement to achieve
an SBP <120 mm Hg to reduce CVD morbidity and mortality.
1 C-LD
2. In adults with T2D and hypertension, antihypertensive drug
treatment should be initiated at a DBP of ≥80 mm Hg with
a treatment goal of <80 mm Hg to reduce CVD morbidity
and mortality.
1 A
3. In adults with T2D and hypertension, all first-line classes of
antihypertensive agents (ie, thiazide-type diuretics, long-acting
CCB, ACEi, and ARB) are useful and effective for BP lowering.
1 A
4. In adults with diabetes and hypertension, ACEi or ARB are
recommended in the presence of CKD as identified by eGFR
<60 mL/min/1.73 m
2
or albuminuria ≥30 mg/g and should
be considered when mild albuminuria (<30 mg/g ) is present
to delay progression of diabetes-related kidney disease.
5.3. Comorbidities
