2024 BP Target 120-129 — EECC MCQ

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ModerateHypertension & Preventive Cardiology2024 BP Target 120-129EECC

A 60-year-old man with hypertension has his BP target discussed. He has diabetes and CKD stage 3a. According to the 2024 ESC Hypertension Guidelines, what is the recommended office BP target?

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Correct answer: A — Office SBP target of 120-129 mmHg (if tolerated) — the 2024 guidelines lowered the SBP target from <130 to 120-129 mmHg for most patients, based on SPRINT and meta-analysis data

The 2024 ESC Hypertension Guidelines made a landmark change: the recommended office SBP target was lowered to 120-129 mmHg (from the previous <130 mmHg) for most treated hypertensive patients, including those with diabetes, CKD, and established CVD. This was based on: (1) SPRINT trial (intensive SBP <120 vs standard <140 reduced MACE by 25% and all-cause mortality by 27%); (2) the Blood Pressure Lowering Treatment Trialists' Collaboration meta-analysis showing continuous benefit of SBP reduction down to 120 mmHg. Key caveats: (1) avoid SBP <120 mmHg; (2) orthostatic hypotension must be excluded (standing BP); (3) elderly and frail patients may need individualised targets; (4) DBP target <80 mmHg.

Reference: ESC (2024): Guidelines for Hypertension