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European guidelines on hypertension more flexible than those in United States

BMJ 2004; 328 doi: https://doi.org/10.1136/bmj.328.7451.1279-c (Published 27 May 2004) Cite this as: BMJ 2004;328:1279

High blood pressure is a 'relative term'

If we see the basic logic behind the levels of blood pressure
declared 'hypertension' it is quite simple i.e., where it causes more
damage to the human body than acceptable. Different blood pressure levels
are used in different big studies/trials and are used as the cutoff
points, also called 'evidence based'. The demographic, social and certain
coexistant medical problems also put these patients into different
categories, and surely the criteria for the diagnosis of high blood
pressure should be different in these different situations, the classic
example being 'Diabetes Mellitus'. Other examples are: a 50 years old
patient's blood vessels tolerates the stress of high blood pressure less
well if his cholestrol is 7.5 than if his cholestrol is 4.5; a patient
with CAD will die earlier with a blood pressure of 170/100 than a patient
who has not got CAD, so and so forth. I think in the presence of other
medical problems the definition of high blood pressure needs to be revised
and individualised as it is of prognostic importance.

Competing interests:
None declared

Competing interests: No competing interests

04 June 2004
Turab Ali
Specialist Registrar in Cardiology
Halton General Hospital, Hospital Way, Runcorn, WA7 2DA