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Your blood pressure is 120 instead of 140? German high pressure league maintains moderate target values
In Germany, around 20 to 30 million people are affected by high blood pressure. Often medication is needed, but a healthier lifestyle is often enough to lower blood pressure. How far this should be reduced is now controversial. The experts of the German Hypertension League maintain moderate target values.
Number one risk factor for cardiovascular diseases
Around 20 to 30 million people in Germany suffer from high blood pressure. Hypertension is usually defined by a systolic blood pressure of over 140 mmHg and a diastolic blood pressure of more than 90 mmHg. Meanwhile, however, the voices are increasing that think that 120 instead of 140 should be the new blood pressure target. The German Hypertension League e.V. DHL® - German Society for Hypertension and Prevention, however, adheres to moderate target values due to the current data situation and emphasizes the need for exact measurements.
Lower blood pressure naturally
Hypertension is not felt by patients for a long time and often only becomes noticeable when it has caused organ damage. He is therefore - like other diseases - referred to as a "silent killer".
The majority of those affected take hypotensive drugs. However, high blood pressure can often be reduced without medication.
In addition to weight loss, regular exercise and abstaining from smoking, a balanced, healthy diet can also help to reduce blood pressure.
It is very important here: salt only in moderation. A high-salt diet can raise blood pressure. No more than four to six grams of salt should be consumed per day.
Some home remedies for high blood pressure, such as Kneipp treatments, can offer good support.
But which blood pressure values should be aimed for?
Study results apply only to certain patients
In 2015, the American SPRINT study found that an intensive lowering of blood pressure to an upper systolic target value of less than 120 mmHg better protects people with high blood pressure from heart attack, stroke, heart failure and cardiovascular death than the previously preferred target value of less than 140 mmHg.
As DHL writes in a recent press release, these study results only apply to certain patients: to people with a high cardiovascular risk, but without diabetes mellitus, not after a stroke or with orthostatic hypotension, i.e. when the upper blood pressure value suddenly drops while standing.
Patients with these diseases were explicitly excluded from the SPRINT study.
Moderate target blood pressure is far from being achieved in everyone
The specialist societies in Canada, Australia and Austria, as well as the ISH (International Society of Hypertension) have recommended a more intensive lowering of blood pressure since the publication of the SPRINT data, even if this often requires the use of additional medication.
DHL's Scientific Opinions and Guidelines Task Force has not fully followed these recommendations in its current opinion.
"Due to the extended data situation according to SPRINT as well as related publications and meta-analyzes, we still recommend a general target value of less than 140/90 mmHg", explained Professor Dr.med. Bernhard Krämer, DHL CEO and member of the task force.
In Germany, the moderate target blood pressure of 140/90 mmHg is currently being achieved in less than 60 percent of patients. "The most important treatment goal for all doctors must therefore be that this blood pressure target is reached," said the expert.
More intense lowering of blood pressure is accompanied by more side effects
Only in cardiovascular risk patients analogous to SPRINT should a value of less than 135/85 mmHg be striven for, according to the "Recommendations 2017".
This applies to patients with previous cardiovascular diseases, other than stroke, aged 75 years or older, with chronic kidney disease CKD 3 and a high vascular risk.
"A more intensive lowering of blood pressure goes hand in hand with more side effects," explained Professor Krämer. "It therefore requires regular laboratory tests on kidney function and electrolytes."
DHL's "Recommendations 2017" were recently published in the "German Medical Weekly Journal".
Blood pressure measurement and norm values
DHL's current statement also deals with blood pressure measurement. An unconventional type of blood pressure measurement - the automated practice blood pressure measurement - was used in the SPRINT study.
It took place after a five-minute rest period with an automatic device in a separate room without the presence of medical or non-medical staff.
"In the long term, this method will not be widely available and practicable in Germany," said Professor Krämer. "It was used to measure values in the SPRINT study that we cannot compare one to one with conventionally measured values."
The "Recommendations 2017" refer to the conventional practice blood pressure measurement.
In Germany, too, more and more patients are checking their blood pressure themselves. DHL expressly supports this, but points out that the measured values are usually somewhat lower than in the doctor's office.
The reason is an increased stress factor when visiting the doctor. A target value of less than 135/85 mmHg therefore applies in self-measurement.
Professor Krämer explained: "At least one week before the next visit to the doctor, patients should take four measurements a day over seven days at home - two in the morning, two in the evening."
The most reliable information about blood pressure is provided by the 24-hour long-term blood pressure measurement. A target value of less than 130/80 mmHg applies here. (ad)