Blood Pressure Targets and Management for Adults

International Guideline Recommendations

The American College of Cardiology/American Heart Association (ACC/AHA) 2022 guideline recommends a general treatment target of systolic < 130 mm Hg and diastolic < 80 mm Hg for adults, provided the regimen is tolerated, and this applies to community‑dwelling adults aged ≥ 65 years. 1
The International Society of Hypertension (ISH) 2020 guideline also recommends blood pressure <130/80 mm Hg for the general population, with individualized targets for elderly patients based on frailty status. 3
The European Society of Cardiology/European Society of Hypertension (ESC/ESH) 2022 guideline advises an initial target of <140/90 mm Hg, progressing to <130/80 mm Hg when the patient tolerates the therapy. 1

Treatment must be well tolerated; clinicians should monitor for adverse effects such as hypotension, syncope, electrolyte disturbances, and falls while aiming for the <130/80 mm Hg target. 1
The blood‑pressure target should be achieved within approximately 3 months after initiating or adjusting antihypertensive therapy, according to the ISH 2020 recommendations. 3
Diastolic pressure should be maintained in the range of 70–79 mm Hg and avoided below 60 mm Hg, especially in patients with coronary artery disease or left‑ventricular hypertrophy, to prevent adverse outcomes. 1