Ideal blood pressure targets for both systolic and diastolic pressure may depend on the cardiovascular event for which an individual patient is most at risk, according to a post-hoc analysis of trial data.

“Our results highlight that while guidelines are important, it is also important to individualise the blood pressure target for the person sitting across from you in the clinic — something doctors and other providers do every day,” says lead author Dr Tara Chang of Stanford University School of Medicine, California, US.

The team used data from ALLHAT (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial) conducted from 1994-2002 to examine the associations of pairs of systolic blood pressure (SBP) and diastolic blood pressure (DBP) measurements with the risk of various outcomes.

In ALLHAT more than 33,000 adults aged 55 and over with at least one CVD risk factor were randomly allocated to a diuretic, chlorthalidone; a calcium channel inhibitor, amlodipine; or the ACEi lisinopril.