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Am Fam Physician. 2022;106(6):721-722

This clinical content conforms to AAFP criteria for CME.

Author disclosure: No relevant financial relationships.

Key Points for Practice

• Blood pressure targets of 140 mm Hg systolic and 90 mm Hg diastolic offer similar reduction in cardiovascular and all-cause mortality as lower targets and have fewer adverse effects.

• Lower blood pressure targets lead to a reduction in myocardial infarction, with a number needed to treat of 137 over 3.7 years.

• After achieving initial blood pressure control, shared decision-making can be used to determine whether lower blood pressure targets should be considered.

From the AFP Editors

Nearly one-third of people in the United States are affected by hypertension, which is a leading cause of premature death. The aim of hypertension treatment is to reduce mortality and morbidity while minimizing harms from medical interventions. Numerous guidelines recommend different blood pressure targets, obscuring the risk-benefit ratio.

The American Academy of Family Physicians (AAFP) updated a recent systematic review with a literature review of subsequent studies to recommend blood pressure targets for primary care management of hypertension.

Primarily Focus on 140/90 mm Hg

Using a blood pressure target of 140/90 mm Hg reduces cardiovascular and all-cause mortality as much as lower targets. Studies in the lower blood pressure target group included target systolic pressures between 120 and 130 mm Hg and diastolic pressures between 65 and 80 mm Hg.

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Coverage of guidelines from other organizations does not imply endorsement by AFP or the AAFP.

This series is coordinated by Michael J. Arnold, MD, associate medical editor.

A collection of Practice Guidelines published in AFP is available at https://www.aafp.org/afp/practguide.

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