[Target blood pressure with antihypertensive therapy and 24-hour-RR measurement]

Abstract

In younger and middle-aged patients treatment should lower the blood pressure to below 140/90 mmHg and in the elderly aged 65 and more to 160/90 mmHg. Numerous interventional studies have shown that this can appreciably reduce the complications of hypertension. However, account must always be taken of the individual risk, so that in a particular case, it might be desirable to aim for lower values, for example, in diabetic nephropathy or when there is a summation of risks. The question as to whether there is a "point of reversal", that is, a renewed increase in complications associated with too great lowering of the blood pressure is still controversial. What is certain is that a lowering of blood pressure that is too rapid and too great can harm the patient with coronary or cerebral vascular stenoses. Better control of the blood pressure is enabled by the 24-hour blood pressure measurement by recording "office hypertension" or "office normotension", intermittent hypertensive or hypotensive phases and, in particular the nocturnal course of the blood pressure (no physiological dip/too pronounced dip).