Scientific evidences for the cut-off points of blood pressure

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  • Miura Katsuyuki
    Department of Public Health, Shiga University of Medical Science Center for Epidemiologic Research in Asia, Shiga University of Medical Science The Japanese Society of Hypertension Committee for Guidelines for the Management of Hypertension

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  • 血圧基準値の科学的根拠

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 Blood pressure (BP) values of a population usually show a normal distribution, and the distribution differs largely by areas and periods, which means BP is a kind of nutritional biomarkers. On the other hand, many epidemiological studies (mainly cohort studies) showed that BP values strongly relate to the future risk of cardiovascular diseases (CVD) and are established CVD risk factors. The relationship is continuous and log-linear and there is no threshold. Therefore, the cut-off point to define “hypertension” is artificial, but it cannot be determined by the cross-sectional data of BP distribution. Now, most of BP treatment guidelines in the world define “hypertension” as BP 140/90 mmHg or over and “optimal BP” as BP less than 120/80 mmHg. The cut-off value of “hypertension” does not mean the implication of drug treatment; however, that of “optimal BP” means the necessity of lifestyle modification. The cut-off BP values reported by the Japan Society of Ningen Dock in 2014 should be retracted because there are many problems and great mistakes.

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