What is the recommended threshold BP for starting antihypertensive medications?
The recommended threshold BP for starting antihypertensive medications is >130/80 mmHg, which is informed by the baseline BPs of patients with cerebrovascular disease studied in trials of BP treatment. Among the 4 RCTs comparing intensive and standard BP targets in patients with prior cerebrovascular disease, the RESPECT190 trials included patients with baseline SBPs as low as 125 mmHg. 50% of patients had baseline SBP <140 mmHg. Similarly, in the PRoFESS trial (Prevention Regimen for Effectively Avoiding Second Strokes) of >20000 patients with isch- 33% of patients had baseline SBP <135 mmHg.