Changes in blood pressure thresholds for initiating antihypertensive medication in patients with diabetes: a repeated cross-sectional study focusing on the impact of age and frailty

Dutch study (n= 4819) found that after an initial rise, observed systolic blood pressure (SBP) thresholds at initiation of antihypertensive decreased over time (mean SBP 157 mm Hg in 2007, 158 mm Hg in 2009, 151 mm Hg in 2014; p<0.001) and were not influenced by age or frailty.

SPS commentary:

Authors note that these findings are in contrast with changed guideline recommendations towards more personalised treatment, which were introduced in 2011, and expected to be observed during the study period, thus they conclude that changing prescribing practice may take considerable time.


BMJ Open