AAFP Blood Pressure Targets in Adults With Hypertension Clinical Guidelines Summary

Summary of Recommendations

Recommendation 1

The American Academy of Family Physicians (AAFP) strongly recommends clinicians treat adults who have hypertension to a standard blood pressure target (less than 140/90 mm Hg) to reduce the risk of all cause and cardiovascular mortality (strong recommendation; high-quality evidence). Treating to a lower blood pressure target (less than 135/85 mm Hg) did not provide additional benefit at preventing mortality; however, a lower blood pressure target could be considered based on clinical assessment and patient preferences and values.

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Table

Table 4. Comparison of Recommended Blood Pressure Targets in Recent Guidelines

Guideline	18 to 59 years of age (mm Hg)	60 to 69 years of age (mm Hg)	70 to 79 years of age (mm Hg)	Older than 80 years (mm Hg)
2022 American Academy of Family Physicians*	< 140/90	< 140/90	< 140/90	< 140/90
2022 National Institute for Health and Care Excellence	< 140/90	< 140/90	< 140/90	< 150/90
2021 European Society of Hypertension Council	< 130/80†	< 130/80†	< 140/80	< 140/80
2020 International Society of Hypertension‡	< 130/80	< 140/90§	< 140/90	< 140/90
2020 U.S. Department of Veterans Affairs/U.S. Department of Defense\|\|	< 130/90¶	< 150/90	< 150/90	< 150/90
2017 American College of Cardiology/American Heart Association*	< 130/80	< 130/80	< 130/80	< 130/80
2017 American College of Physicians and American Academy of Family Physicians	N/A	< 150/90	< 150/90	< 150/90
2014 Eighth Joint National Committee	< 140/90	< 150/90	< 150/90	< 150/90

*—Lower targets are reasonable based on clinical judgment and patient preferences or values
†—A target of less than 140/90 mm Hg is recommended for patients with chronic kidney disease.
‡—Recommendation is to treat all patients to less than 140/90 mm Hg but states it is optimal to treat persons younger than 65 years and people with coronary artery disease, chronic kidney disease, heart failure, previous stroke, chronic obstructive pulmonary disease, or diabetes mellitus to less than 130/80 mm Hg (less than 140/80 mm Hg in older patients).
§—Recommendation is to transition from target of 130/80 mm Hg to 140/90 mm Hg at 65 years of age.
||—A target of less than 140/90 mm Hg is recommended in patients with diabetes.
¶—Recommendation is to treat all patients 18 to 59 years of age (including those with diabetes) to a systolic blood pressure target of less than 130 mm Hg. For patients 30 years and older, a diastolic blood pressure target of less than 90 mm Hg is recommended.

Overview

Title

Blood Pressure Targets in Adults With Hypertension