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For most people, recommendations are to reduce blood pressure to less than or equal to somewhere between 140/90 mmHg and 160/100 mmHg. [2] In general, for people with elevated blood pressure, attempting to achieve lower levels of blood pressure than the recommended 140/90 mmHg will create more harm than benefits, [3] in particular for older people. [4]
Antihypertensive therapy seeks to prevent the complications of high blood pressure, such as stroke, heart failure, kidney failure and myocardial infarction. Evidence suggests that a reduction of blood pressure by 5 mmHg can decrease the risk of stroke by 34% and of ischaemic heart disease by 21%.
Goal blood pressure (mmHg) Initial treatment options ESC 2024 [2] General 120–129/70–79 BP >140/90: Two from different classes: preferably RAS-inhibitor (ACEI or ARB) with either thiazide diuretic/thiazide-like diuretic or dihydropyridine CCB. ESH 2023 [3] General age <65 General age 65–79 General age ≥80 <130/80 <140 SBP <150 SBP
The following are medications commonly prescribed cardiac pharmaceutical agents. The specificity of the following medications is highly variable, and often are not particularly specific to a given class. As such, they are listed as are commonly accepted.
Calcium channel blockers are used as antihypertensive drugs, i.e., as medications to decrease blood pressure in patients with hypertension. CCBs are particularly effective against large vessel stiffness, one of the common causes of elevated systolic blood pressure in elderly patients. [4]
"Your blood pressure is supposed to be under 140 over 90, optimally closer to 120 over 80."