What does the current guideline recommend as her blood pressure target?

AKAnna Keller, 47 · Hypertension, prediabetes, LDL 162 mg/dl · 14 documents, read 16 September 2026

Answered on 16 September 2026

Practice guidelineEuropean Society of Cardiology

The 2024 ESC guideline recommends a systolic target of 120 to 129 mmHg for most adults on treatment, provided it is tolerated, and home blood pressure monitoring to guide treatment; home readings run about 5 mmHg below office values. Eur Heart J

European Society of Cardiology

2024 ESC Guidelines for the management of elevated blood pressure and hypertension.

McEvoy JW, McCarthy CP, Bruno RM, et al. European Heart Journal. 2024;45:3912-4018. doi:10.1093/eurheartj/ehae178.

For her: home mean 136/86 mmHg and office 142/90 are above target on ramipril 5 mg. BP log 15.09.2026 Visit 16.09.2026 The guideline's first step is to optimise the existing drug or move to a combination; with eGFR 92 and normal potassium, ramipril 10 mg is the straightforward step, with a combination (ramipril plus amlodipine) if the home mean stays above 135/85 after four weeks. Lab 08.05.2026 Eur Heart J

Home measurement: seated after five minutes of rest, two readings in the morning and two in the evening for seven days, discarding the first day. Her log follows that scheme. BP log 15.09.2026 Eur Heart J

From the patient record3 of 14 documents

Home blood pressure log, 9 to 15 September, 15 September 2026Patient data
Visit note, today's consultation (draft), 16 September 2026Clinical note
Laboratory report, 8 May 2026Laboratory

1.2024 ESC Guidelines for the management of elevated blood pressure and hypertension.European Heart Journal. 2024;45:3912-4018. McEvoy JW, McCarthy CP, Bruno RM, et al.Guideline
SummaryIntroduces the category “elevated blood pressure” (120 to 139/70 to 89 mmHg) and recommends a treated systolic target of 120 to 129 mmHg for most adults if tolerated. Home blood pressure monitoring is recommended to confirm the diagnosis and guide treatment: seated after five minutes of rest, two readings morning and evening for at least three, ideally seven days. Combination therapy is preferred when one drug is insufficient.
Source
Issuing body: European Society of Cardiology
Published: August 2024
Grading system: ESC classes of recommendation I–III, levels of evidence A–C
Scope
Target population: Adults with elevated blood pressure or hypertension
Scope: Diagnosis, targets, lifestyle, drug therapy, monitoring

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