Abstract
The target of antihypertensive therapy has been lowered gradually. Number of patients under antihypertensive therapy are increasing accordingly. Cost used for the therapy is most expensive among all medical treatments. We have verified the clinical guideline for antihypertensive therapy used in Japan. We performed cohort study to compare blood pressure levels and mortality in general population, calculated hazard rates of antihypertensive therapy in general population and odds ratio of hypertension and antihypertensive therapy between general population and patients with stroke. The total mortality and the death rate from cardiovascular disease were in lowest level until SBP/DBP of 160/100 mmHg. The death rate in persons with blood pressure more than 180/110 mmHg at the baseline and blood pressure under 160/100 mmHg at the end point was increased four times than that in the persons who had mild reduction of blood pressure (to 160-179/100-109 mmHg). The odds ratio of antihypertensive therapy was about 3.0 in patients with stroke compared with general population. Intensive blood pressure lowering may cause increase of total mortality and incidence of stroke. 160/100 mmHg is eligible for the target of the therapy to general population. Reduction of systolic blood pressure for the aged by drugs is desirable within 20 mmHg.
