# Blood-pressure lowering to a target Intervention · id `cardio:bp-lowering-to-target` · Cardiovascular Atlas · release `2b2017b84496b985` (public) > General information from published sources, not medical advice, and not reviewed by clinicians. Check the cited source before relying on anything here. The atlas's own text and curation may be reused under Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0, https://creativecommons.org/licenses/by-nc/4.0/): credit the atlas, and do not use it commercially. See the atlas About page. Text quoted from a source stays under that source's own terms, given as the source's reuse\_basis. The atlas's reuse terms do not cover it. The downloads list each quotation with its source in third\_party\_quotations. Browse, organ or system: Blood vessels Browse, condition area: High blood pressure ## In plain language Using medicines and lifestyle changes to bring blood pressure below a chosen number and keep it there. ## Technical summary Generic treat-to-target antihypertensive management. The target belongs to the guideline context or study arm, not to this entity. ## Claims, with the population each applies to ## Context: Adults with elevated blood pressure or hypertension (2024 ESC guideline) Recipient: Adult; Population: Adults with elevated blood pressure or hypertension. Age limits and pregnancy handling are not stated in the sources read.; Care setting: Not stated in the sources read; Geography: Not stated in the sources read (guideline of the European Society of Cardiology; applicability by country not verified); Life stage: Adult; Follow-up: Not applicable (guideline context) ### The European Society of Cardiology's summary of its 2024 guideline gives 120 to 129 mmHg systolic and 70 to 79 mmHg diastolic as the pressure to aim for during treatment in all adults, if the treatment is well tolerated. It says the aim is the same whatever the pressure at which treatment is advised to start. It also says there are a number of important exceptions, and that decisions made for the individual patient always come first. - Category: Recommendation - Evidence stage: Guidance - Certainty: Certainty not assessed - Applies to: Recipient: Adult; Population: Adults with elevated blood pressure or hypertension. Age limits and pregnancy handling are not stated in the sources read.; Care setting: Not stated in the sources read; Geography: Not stated in the sources read (guideline of the European Society of Cardiology; applicability by country not verified); Life stage: Adult; Follow-up: Not applicable (guideline context) - Limitations: The source is the ESC's condensed Essential Messages, not the recommendation tables, so the class of recommendation, the level of evidence, the exceptions and the pressure at which to start treatment were not read. This is a claim only and has no recommendation decision. Two later corrections are listed in PubMed, their text was not read, and the Essential Messages was produced before both, so whether the corrections change the target given here is unknown. Any other guideline states its own target. A claim about another guideline is recorded separately and is not reconciled with this one, so this claim does not say which target is right. Pregnancy handling is not stated in the sources read. - Last checked: Not recorded - Source problem: a cited source is corrected. Check the sources before relying on this claim. - Sources: 1. Supports: 2024 ESC Guidelines for the management of elevated blood pressure and hypertension (Guideline, edition Issued by the European Society of Cardiology and published in European Heart Journal 45(38):3912-4018. The publisher field is the journal publisher as Crossref names it. Publisher summary only. The version of record was not read: doi.org and academic.oup.com returned HTTP 403 (a Cloudflare challenge), PubMed holds no abstract for it, and Europe PMC lists it as subscription required. The facts come from the ESC Essential Messages PDF for this guideline, found through the ESC Essential messages page, and from the ESC guideline page. Two later corrections are listed in PubMed (Eur Heart J 2025 Apr 7;46(14):1300, doi 10.1093/eurheartj/ehaf031, and 2025 Dec 1;46(45):4949, doi 10.1093/eurheartj/ehaf659). Their text was not read, and the Essential Messages was produced before both.) Locator: Section 1 Key messages, message 10. Retrieved 2026-10-11T19:13:32Z. Source state: Corrected. Snapshot hash: 1002525ded65298879e25304fbc88d4af91631b7dd4977df3ec2e67f504ffd98. How it applies: ESC Essential Messages PDF for the 2024 guideline. 2. Background: 2024 ESC Guidelines for the management of elevated blood pressure and hypertension (Guideline, edition Issued by the European Society of Cardiology and published in European Heart Journal 45(38):3912-4018. The publisher field is the journal publisher as Crossref names it. Publisher summary only. The version of record was not read: doi.org and academic.oup.com returned HTTP 403 (a Cloudflare challenge), PubMed holds no abstract for it, and Europe PMC lists it as subscription required. The facts come from the ESC Essential Messages PDF for this guideline, found through the ESC Essential messages page, and from the ESC guideline page. Two later corrections are listed in PubMed (Eur Heart J 2025 Apr 7;46(14):1300, doi 10.1093/eurheartj/ehaf031, and 2025 Dec 1;46(45):4949, doi 10.1093/eurheartj/ehaf659). Their text was not read, and the Essential Messages was produced before both.) Locator: Back page, corrections notice. Retrieved 2026-10-11T19:13:32Z. Source state: Corrected. Snapshot hash: 1002525ded65298879e25304fbc88d4af91631b7dd4977df3ec2e67f504ffd98. How it applies: The ESC says it posts corrections and updates made after publication on its guidelines page. 3. Background: 2024 ESC Guidelines for the management of elevated blood pressure and hypertension (Guideline, edition Issued by the European Society of Cardiology and published in European Heart Journal 45(38):3912-4018. The publisher field is the journal publisher as Crossref names it. Publisher summary only. The version of record was not read: doi.org and academic.oup.com returned HTTP 403 (a Cloudflare challenge), PubMed holds no abstract for it, and Europe PMC lists it as subscription required. The facts come from the ESC Essential Messages PDF for this guideline, found through the ESC Essential messages page, and from the ESC guideline page. Two later corrections are listed in PubMed (Eur Heart J 2025 Apr 7;46(14):1300, doi 10.1093/eurheartj/ehaf031, and 2025 Dec 1;46(45):4949, doi 10.1093/eurheartj/ehaf659). Their text was not read, and the Essential Messages was produced before both.) Locator: CommentsCorrectionsList, two ErratumIn entries. Retrieved 2026-10-11T19:12:57Z. Source state: Corrected. Snapshot hash: f9afb12c7dd4e0a09ed8cba2fbbc89cf98fe1655ea1bfe1bb04012b061740281. How it applies: Shows that two corrections exist. What they change is unknown. ## Context: Adults with hypertension aged under 80 (NICE NG136 recommendation 1.4.20) Recipient: Adult; Population: Adults with hypertension aged under 80, with or without type 2 diabetes (NG136 Table 1); Care setting: Not stated on the fetched page; Geography: Not stated on the fetched page (NICE guidance; jurisdiction not verified); Life stage: Adult under 80; Follow-up: Not applicable (recommendation context) ### NICE guideline NG136 recommends lowering clinic blood pressure below 140/90 mmHg, and keeping it there, for adults with hypertension aged under 80. - Category: Recommendation - Evidence stage: Guidance - Certainty: Certainty not assessed - Applies to: Recipient: Adult; Population: Adults with hypertension aged under 80, with or without type 2 diabetes (NG136 Table 1); Care setting: Not stated on the fetched page; Geography: Not stated on the fetched page (NICE guidance; jurisdiction not verified); Life stage: Adult under 80; Follow-up: Not applicable (recommendation context) - Limitations: NICE's population includes people with type 2 diabetes, whom SPRINT excluded. The fetched page gives no strength label for this imperative wording (a pair of directive verbs, one to lower the pressure and one to keep it there), and NICE's page on recommendation wording explains only the verbs offer and consider. The jurisdiction is not stated on the fetched page. The recommendation carries the tag 2019, amended 2022; the exact amendment date was not recorded. This claim records what NICE recommends. It does not say that NICE assessed or rejected SPRINT's target. - Last checked: Not recorded - Sources: 1. Supports: Hypertension in adults: diagnosis and management (NICE guideline NG136), Recommendations chapter (Guideline, edition The Recommendations chapter as shown on 2026-10-09 and fetched again on 2026-10-11 with identical bytes. The page header gives 26 February 2026 as the last update. This atlas cites six recommendations from it, each with the version tag the page shows: 1.1.3 is tagged \[2004\]; 1.2.3, 1.2.4 and 1.2.8 are tagged \[2019\]; 1.4.5 is tagged \[2004, amended 2019\]; 1.4.20 is tagged \[2019, amended 2022\]. Which edition of each recommendation these tags point to was not checked.) Locator: Recommendation 1.4.20, the sentence on adults aged under 80. Retrieved 2026-10-09T15:59:21Z. Source state: Current. Snapshot hash: 68ce72f3487ffa4715f92ddfa8aaf6e093f5aecd3598cd59a0ab58f74ce86f28. How it applies: NICE NG136 as shown on 2026-10-09, last updated 2026-02-26. 2. Background: Hypertension in adults: diagnosis and management (NICE guideline NG136), Recommendations chapter (Guideline, edition The Recommendations chapter as shown on 2026-10-09 and fetched again on 2026-10-11 with identical bytes. The page header gives 26 February 2026 as the last update. This atlas cites six recommendations from it, each with the version tag the page shows: 1.1.3 is tagged \[2004\]; 1.2.3, 1.2.4 and 1.2.8 are tagged \[2019\]; 1.4.5 is tagged \[2004, amended 2019\]; 1.4.20 is tagged \[2019, amended 2022\]. Which edition of each recommendation these tags point to was not checked.) Locator: Recommendation 1.4.20, version tag. Retrieved 2026-10-09T15:59:21Z. Source state: Current. Snapshot hash: 68ce72f3487ffa4715f92ddfa8aaf6e093f5aecd3598cd59a0ab58f74ce86f28. How it applies: Dates the wording of this recommendation. 3. Background: Making decisions using NICE guidelines (Webpage) Locator: Section on recommendation wording, the sentence on the verb offer. Retrieved 2026-10-09T15:59:49Z. Source state: Current. Snapshot hash: b7838d1bdb692f2b6dfc71480aa95803d68c64aa0dde406375953c9479aaae7c. How it applies: Explains how NICE uses the verb offer. It does not say what strength imperative verbs such as reduce carry. ## Context: Adults with hypertension at high risk (WHO 2021 recommendation 6c) Recipient: Adult; Population: Adults with hypertension who are at high risk, which WHO lists as high cardiovascular risk, diabetes mellitus or chronic kidney disease. WHO says the guideline targets non-pregnant adults.; Care setting: Not stated for this recommendation in the source; Geography: Global WHO guidance; national adoption not recorded; Life stage: Adult; Follow-up: Not applicable (recommendation context) ### WHO suggests a systolic blood pressure target of below 130 mmHg for adults with hypertension who are at high risk because of high cardiovascular risk, diabetes or chronic kidney disease. - Category: Recommendation - Evidence stage: Guidance - Certainty: Moderate certainty (method: The certainty is the GRADE level WHO prints in the strength label of this recommendation. It is WHO's assessment of the evidence base, not an assessment by this atlas.) - Applies to: Recipient: Adult; Population: Adults with hypertension who are at high risk, which WHO lists as high cardiovascular risk, diabetes mellitus or chronic kidney disease. WHO says the guideline targets non-pregnant adults.; Care setting: Not stated for this recommendation in the source; Geography: Global WHO guidance; national adoption not recorded; Life stage: Adult; Follow-up: Not applicable (recommendation context) - Limitations: WHO labels this statement "Conditional recommendation, moderate-certainty evidence". It is a suggestion, weaker than 6a and 6b. The certainty above is that label. Global WHO guidance written for adults who are not pregnant; national adoption is not recorded. No evidence review behind the recommendation was read by this cluster. The WHO publication page and the PDF disagree on the page count (48 versus 61); this was not resolved. - Last checked: 2026-10-11 - Sources: 1. Supports: Guideline for the pharmacological treatment of hypertension in adults (World Health Organization, 2021) (Guideline, edition Two snapshots of one edition, fetched on 2026-10-11: the WHO publication page, and the English PDF through the IRIS REST bitstream (843539 bytes, 61 pages counted from the file). The publication page states 48 pages. This cluster did not resolve the difference. A separate WHO summary edition exists and was not fetched.) Locator: PDF page 28, section 3.6, recommendation 6, third statement (part 1). Retrieved 2026-10-11T19:11:40Z. Source state: Current. Snapshot hash: 57f6376d5c9bc4ea6c44873625547c8a5443d5a6ad8c8c422733681563db05fb. How it applies: The target and the population. 2. Supports: Guideline for the pharmacological treatment of hypertension in adults (World Health Organization, 2021) (Guideline, edition Two snapshots of one edition, fetched on 2026-10-11: the WHO publication page, and the English PDF through the IRIS REST bitstream (843539 bytes, 61 pages counted from the file). The publication page states 48 pages. This cluster did not resolve the difference. A separate WHO summary edition exists and was not fetched.) Locator: PDF page 28, section 3.6, recommendation 6, third statement (part 2). Retrieved 2026-10-11T19:11:40Z. Source state: Current. Snapshot hash: 57f6376d5c9bc4ea6c44873625547c8a5443d5a6ad8c8c422733681563db05fb. How it applies: The remaining high-risk conditions. 3. Background: Guideline for the pharmacological treatment of hypertension in adults (World Health Organization, 2021) (Guideline, edition Two snapshots of one edition, fetched on 2026-10-11: the WHO publication page, and the English PDF through the IRIS REST bitstream (843539 bytes, 61 pages counted from the file). The publication page states 48 pages. This cluster did not resolve the difference. A separate WHO summary edition exists and was not fetched.) Locator: PDF page 28, section 3.6, recommendation 6, third statement, strength label. Retrieved 2026-10-11T19:11:40Z. Source state: Current. Snapshot hash: 57f6376d5c9bc4ea6c44873625547c8a5443d5a6ad8c8c422733681563db05fb. How it applies: The strength label WHO prints under the statement: Conditional recommendation, moderate-certainty evidence 4. Background: Guideline for the pharmacological treatment of hypertension in adults (World Health Organization, 2021) (Guideline, edition Two snapshots of one edition, fetched on 2026-10-11: the WHO publication page, and the English PDF through the IRIS REST bitstream (843539 bytes, 61 pages counted from the file). The publication page states 48 pages. This cluster did not resolve the difference. A separate WHO summary edition exists and was not fetched.) Locator: PDF page 9, Executive summary, paragraph 2, sentence 2. Retrieved 2026-10-11T19:11:40Z. Source state: Current. Snapshot hash: 57f6376d5c9bc4ea6c44873625547c8a5443d5a6ad8c8c422733681563db05fb. How it applies: WHO scope: adult, non-pregnant patients appropriately diagnosed with hypertension and counselled about lifestyle. 5. Background: Guideline for the pharmacological treatment of hypertension in adults (World Health Organization, 2021) (Guideline, edition Two snapshots of one edition, fetched on 2026-10-11: the WHO publication page, and the English PDF through the IRIS REST bitstream (843539 bytes, 61 pages counted from the file). The publication page states 48 pages. This cluster did not resolve the difference. A separate WHO summary edition exists and was not fetched.) Locator: PDF page 9, Executive summary, paragraph 4, sentence 4. Retrieved 2026-10-11T19:11:40Z. Source state: Current. Snapshot hash: 57f6376d5c9bc4ea6c44873625547c8a5443d5a6ad8c8c422733681563db05fb. How it applies: WHO says it built summary of findings tables with the GRADE approach. ## Context: Adults with hypertension without comorbidities (WHO 2021 recommendation 6a) Recipient: Adult; Population: Adults with hypertension and no comorbidities. The recommendation statement does not define comorbidities. The rationale on the same page (PDF page 28) names them: "In patients with comorbidity (CAD, DM, CKD) there is consistent benefit with lower targets", where WHO's list of acronyms gives CAD as coronary artery disease, DM as diabetes mellitus and CKD as chronic kidney disease. WHO says the guideline targets non-pregnant adults.; Care setting: Not stated for this recommendation in the source; Geography: Global WHO guidance; national adoption not recorded; Life stage: Adult; Follow-up: Not applicable (recommendation context) ### WHO recommends a blood pressure target of below 140/90 mmHg for adults with hypertension who have no comorbidities. - Category: Recommendation - Evidence stage: Guidance - Certainty: Moderate certainty (method: The certainty is the GRADE level WHO prints in the strength label of this recommendation. It is WHO's assessment of the evidence base, not an assessment by this atlas.) - Applies to: Recipient: Adult; Population: Adults with hypertension and no comorbidities. The recommendation statement does not define comorbidities. The rationale on the same page (PDF page 28) names them: "In patients with comorbidity (CAD, DM, CKD) there is consistent benefit with lower targets", where WHO's list of acronyms gives CAD as coronary artery disease, DM as diabetes mellitus and CKD as chronic kidney disease. WHO says the guideline targets non-pregnant adults.; Care setting: Not stated for this recommendation in the source; Geography: Global WHO guidance; national adoption not recorded; Life stage: Adult; Follow-up: Not applicable (recommendation context) - Limitations: WHO labels this statement "Strong recommendation, moderate-certainty evidence". The certainty above is that label. The recommendation statement does not define comorbidities. The rationale on the same page (PDF page 28) names them: "In patients with comorbidity (CAD, DM, CKD) there is consistent benefit with lower targets", where WHO's list of acronyms gives CAD as coronary artery disease, DM as diabetes mellitus and CKD as chronic kidney disease. Statements 6b and 6c set a lower systolic target for two other groups. NICE sets its own target in a separate claim. Global WHO guidance written for adults who are not pregnant; national adoption is not recorded. No evidence review behind the recommendation was read by this cluster. The WHO publication page and the PDF disagree on the page count (48 versus 61); this was not resolved. - Last checked: 2026-10-11 - Sources: 1. Supports: Guideline for the pharmacological treatment of hypertension in adults (World Health Organization, 2021) (Guideline, edition Two snapshots of one edition, fetched on 2026-10-11: the WHO publication page, and the English PDF through the IRIS REST bitstream (843539 bytes, 61 pages counted from the file). The publication page states 48 pages. This cluster did not resolve the difference. A separate WHO summary edition exists and was not fetched.) Locator: PDF page 28, section 3.6, recommendation 6, first statement. Retrieved 2026-10-11T19:11:40Z. Source state: Current. Snapshot hash: 57f6376d5c9bc4ea6c44873625547c8a5443d5a6ad8c8c422733681563db05fb. How it applies: The target and the population. 2. Background: Guideline for the pharmacological treatment of hypertension in adults (World Health Organization, 2021) (Guideline, edition Two snapshots of one edition, fetched on 2026-10-11: the WHO publication page, and the English PDF through the IRIS REST bitstream (843539 bytes, 61 pages counted from the file). The publication page states 48 pages. This cluster did not resolve the difference. A separate WHO summary edition exists and was not fetched.) Locator: PDF page 28, section 3.6, recommendation 6, first statement, strength label. Retrieved 2026-10-11T19:11:40Z. Source state: Current. Snapshot hash: 57f6376d5c9bc4ea6c44873625547c8a5443d5a6ad8c8c422733681563db05fb. How it applies: The strength label WHO prints under the statement: Strong recommendation, moderate-certainty evidence 3. Background: Guideline for the pharmacological treatment of hypertension in adults (World Health Organization, 2021) (Guideline, edition Two snapshots of one edition, fetched on 2026-10-11: the WHO publication page, and the English PDF through the IRIS REST bitstream (843539 bytes, 61 pages counted from the file). The publication page states 48 pages. This cluster did not resolve the difference. A separate WHO summary edition exists and was not fetched.) Locator: PDF page 28, section 3.6, Evidence and rationale, sentence on comorbidity (CAD, DM, CKD). Retrieved 2026-10-11T19:11:40Z. Source state: Current. Snapshot hash: 57f6376d5c9bc4ea6c44873625547c8a5443d5a6ad8c8c422733681563db05fb. How it applies: The comorbidities WHO names beside the statement. 4. Background: Guideline for the pharmacological treatment of hypertension in adults (World Health Organization, 2021) (Guideline, edition Two snapshots of one edition, fetched on 2026-10-11: the WHO publication page, and the English PDF through the IRIS REST bitstream (843539 bytes, 61 pages counted from the file). The publication page states 48 pages. This cluster did not resolve the difference. A separate WHO summary edition exists and was not fetched.) Locator: PDF page 9, Executive summary, paragraph 2, sentence 2. Retrieved 2026-10-11T19:11:40Z. Source state: Current. Snapshot hash: 57f6376d5c9bc4ea6c44873625547c8a5443d5a6ad8c8c422733681563db05fb. How it applies: WHO scope: adult, non-pregnant patients appropriately diagnosed with hypertension and counselled about lifestyle. 5. Background: Guideline for the pharmacological treatment of hypertension in adults (World Health Organization, 2021) (Guideline, edition Two snapshots of one edition, fetched on 2026-10-11: the WHO publication page, and the English PDF through the IRIS REST bitstream (843539 bytes, 61 pages counted from the file). The publication page states 48 pages. This cluster did not resolve the difference. A separate WHO summary edition exists and was not fetched.) Locator: PDF page 9, Executive summary, paragraph 4, sentence 4. Retrieved 2026-10-11T19:11:40Z. Source state: Current. Snapshot hash: 57f6376d5c9bc4ea6c44873625547c8a5443d5a6ad8c8c422733681563db05fb. How it applies: WHO says it built summary of findings tables with the GRADE approach. ## Context: Adults with hypertension and known cardiovascular disease (WHO 2021 recommendation 6b) Recipient: Adult; Population: Adults with hypertension and known cardiovascular disease. WHO says the guideline targets non-pregnant adults.; Care setting: Not stated for this recommendation in the source; Geography: Global WHO guidance; national adoption not recorded; Life stage: Adult; Follow-up: Not applicable (recommendation context) ### WHO recommends a systolic blood pressure target of below 130 mmHg for adults with hypertension and known cardiovascular disease. - Category: Recommendation - Evidence stage: Guidance - Certainty: Moderate certainty (method: The certainty is the GRADE level WHO prints in the strength label of this recommendation. It is WHO's assessment of the evidence base, not an assessment by this atlas.) - Applies to: Recipient: Adult; Population: Adults with hypertension and known cardiovascular disease. WHO says the guideline targets non-pregnant adults.; Care setting: Not stated for this recommendation in the source; Geography: Global WHO guidance; national adoption not recorded; Life stage: Adult; Follow-up: Not applicable (recommendation context) - Limitations: WHO labels this statement "Strong recommendation, moderate-certainty evidence". The certainty above is that label. Global WHO guidance written for adults who are not pregnant; national adoption is not recorded. No evidence review behind the recommendation was read by this cluster. The WHO publication page and the PDF disagree on the page count (48 versus 61); this was not resolved. - Last checked: 2026-10-11 - Sources: 1. Supports: Guideline for the pharmacological treatment of hypertension in adults (World Health Organization, 2021) (Guideline, edition Two snapshots of one edition, fetched on 2026-10-11: the WHO publication page, and the English PDF through the IRIS REST bitstream (843539 bytes, 61 pages counted from the file). The publication page states 48 pages. This cluster did not resolve the difference. A separate WHO summary edition exists and was not fetched.) Locator: PDF page 28, section 3.6, recommendation 6, second statement. Retrieved 2026-10-11T19:11:40Z. Source state: Current. Snapshot hash: 57f6376d5c9bc4ea6c44873625547c8a5443d5a6ad8c8c422733681563db05fb. How it applies: The target and the population. 2. Background: Guideline for the pharmacological treatment of hypertension in adults (World Health Organization, 2021) (Guideline, edition Two snapshots of one edition, fetched on 2026-10-11: the WHO publication page, and the English PDF through the IRIS REST bitstream (843539 bytes, 61 pages counted from the file). The publication page states 48 pages. This cluster did not resolve the difference. A separate WHO summary edition exists and was not fetched.) Locator: PDF page 28, section 3.6, recommendation 6, second statement, strength label. Retrieved 2026-10-11T19:11:40Z. Source state: Current. Snapshot hash: 57f6376d5c9bc4ea6c44873625547c8a5443d5a6ad8c8c422733681563db05fb. How it applies: The strength label WHO prints under the statement: Strong recommendation, moderate-certainty evidence 3. Background: Guideline for the pharmacological treatment of hypertension in adults (World Health Organization, 2021) (Guideline, edition Two snapshots of one edition, fetched on 2026-10-11: the WHO publication page, and the English PDF through the IRIS REST bitstream (843539 bytes, 61 pages counted from the file). The publication page states 48 pages. This cluster did not resolve the difference. A separate WHO summary edition exists and was not fetched.) Locator: PDF page 9, Executive summary, paragraph 2, sentence 2. Retrieved 2026-10-11T19:11:40Z. Source state: Current. Snapshot hash: 57f6376d5c9bc4ea6c44873625547c8a5443d5a6ad8c8c422733681563db05fb. How it applies: WHO scope: adult, non-pregnant patients appropriately diagnosed with hypertension and counselled about lifestyle. 4. Background: Guideline for the pharmacological treatment of hypertension in adults (World Health Organization, 2021) (Guideline, edition Two snapshots of one edition, fetched on 2026-10-11: the WHO publication page, and the English PDF through the IRIS REST bitstream (843539 bytes, 61 pages counted from the file). The publication page states 48 pages. This cluster did not resolve the difference. A separate WHO summary edition exists and was not fetched.) Locator: PDF page 9, Executive summary, paragraph 4, sentence 4. Retrieved 2026-10-11T19:11:40Z. Source state: Current. Snapshot hash: 57f6376d5c9bc4ea6c44873625547c8a5443d5a6ad8c8c422733681563db05fb. How it applies: WHO says it built summary of findings tables with the GRADE approach. ## Guidance, authorization and access ### Recommendation `cardio:rec-nice-ng136-1-4-20` - Intervention: Blood-pressure lowering to a target (`cardio:bp-lowering-to-target`) - Direction: Recommended - Issued by: National Institute for Health and Care Excellence (`cardio:nice`) - Guideline: Hypertension in adults: diagnosis and management (NICE guideline NG136), Recommendations chapter, edition The Recommendations chapter as shown on 2026-10-09 and fetched again on 2026-10-11 with identical bytes. The page header gives 26 February 2026 as the last update. This atlas cites six recommendations from it, each with the version tag the page shows: 1.1.3 is tagged \[2004\]; 1.2.3, 1.2.4 and 1.2.8 are tagged \[2019\]; 1.4.5 is tagged \[2004, amended 2019\]; 1.4.20 is tagged \[2019, amended 2022\]. Which edition of each recommendation these tags point to was not checked.; snapshot `cardio:nice-ng136-recs-2026-10-09` - Jurisdiction: Not stated on the fetched page - Strength: Not labeled on the fetched page. The recommendation uses imperative wording (directive verbs to lower the pressure and to keep it there). (NICE wording convention. The fetched NICE page explains only that NICE uses the verb offer where the evidence of benefit is strong and leaves little doubt, and the verb consider where the benefit is less certain. How NICE treats imperative verbs was not verified.) - Effective: 2019-08-28 (The date NG136 was first published. Recommendation 1.4.20 carries the tag 2019, amended 2022, so it was amended in 2022. The page shows a last update of 26 February 2026.) - Applies to: Recipient: Adult; Population: Adults with hypertension aged under 80, with or without type 2 diabetes (NG136 Table 1); Care setting: Not stated on the fetched page; Geography: Not stated on the fetched page (NICE guidance; jurisdiction not verified); Life stage: Adult under 80; Follow-up: Not applicable (recommendation context) - Basis: claim `cardio:claim-nice-ng136-target-under-80` ### Recommendation `cardio:rec-who-2021-r6a` - Intervention: Blood-pressure lowering to a target (`cardio:bp-lowering-to-target`) - Direction: Recommended - Issued by: World Health Organization (`cardio:who`) - Guideline: Guideline for the pharmacological treatment of hypertension in adults (World Health Organization, 2021), edition Two snapshots of one edition, fetched on 2026-10-11: the WHO publication page, and the English PDF through the IRIS REST bitstream (843539 bytes, 61 pages counted from the file). The publication page states 48 pages. This cluster did not resolve the difference. A separate WHO summary edition exists and was not fetched.; snapshot `cardio:who-9789240033986-eng-pdf-2026-10-11` - Jurisdiction: Global WHO guidance; national adoption not recorded - Strength: Strong recommendation, moderate-certainty evidence (GRADE. Section 2.5 of the WHO guideline (PDF page 17) says the guideline development group rated the certainty of evidence and developed the recommendations with the GRADE approach, and it defines a strong recommendation and a weak or conditional one.) - Effective: 2021-08-24 (The publication date on the WHO publication page.) - Supersession: Not checked - Applies to: Recipient: Adult; Population: Adults with hypertension and no comorbidities. The recommendation statement does not define comorbidities. The rationale on the same page (PDF page 28) names them: "In patients with comorbidity (CAD, DM, CKD) there is consistent benefit with lower targets", where WHO's list of acronyms gives CAD as coronary artery disease, DM as diabetes mellitus and CKD as chronic kidney disease. WHO says the guideline targets non-pregnant adults.; Care setting: Not stated for this recommendation in the source; Geography: Global WHO guidance; national adoption not recorded; Life stage: Adult; Follow-up: Not applicable (recommendation context) - Basis: claim `cardio:claim-who-2021-r6a` ### Recommendation `cardio:rec-who-2021-r6b` - Intervention: Blood-pressure lowering to a target (`cardio:bp-lowering-to-target`) - Direction: Recommended - Issued by: World Health Organization (`cardio:who`) - Guideline: Guideline for the pharmacological treatment of hypertension in adults (World Health Organization, 2021), edition Two snapshots of one edition, fetched on 2026-10-11: the WHO publication page, and the English PDF through the IRIS REST bitstream (843539 bytes, 61 pages counted from the file). The publication page states 48 pages. This cluster did not resolve the difference. A separate WHO summary edition exists and was not fetched.; snapshot `cardio:who-9789240033986-eng-pdf-2026-10-11` - Jurisdiction: Global WHO guidance; national adoption not recorded - Strength: Strong recommendation, moderate-certainty evidence (GRADE. Section 2.5 of the WHO guideline (PDF page 17) says the guideline development group rated the certainty of evidence and developed the recommendations with the GRADE approach, and it defines a strong recommendation and a weak or conditional one.) - Effective: 2021-08-24 (The publication date on the WHO publication page.) - Supersession: Not checked - Applies to: Recipient: Adult; Population: Adults with hypertension and known cardiovascular disease. WHO says the guideline targets non-pregnant adults.; Care setting: Not stated for this recommendation in the source; Geography: Global WHO guidance; national adoption not recorded; Life stage: Adult; Follow-up: Not applicable (recommendation context) - Basis: claim `cardio:claim-who-2021-r6b` ### Recommendation `cardio:rec-who-2021-r6c` - Intervention: Blood-pressure lowering to a target (`cardio:bp-lowering-to-target`) - Direction: Recommended - Issued by: World Health Organization (`cardio:who`) - Guideline: Guideline for the pharmacological treatment of hypertension in adults (World Health Organization, 2021), edition Two snapshots of one edition, fetched on 2026-10-11: the WHO publication page, and the English PDF through the IRIS REST bitstream (843539 bytes, 61 pages counted from the file). The publication page states 48 pages. This cluster did not resolve the difference. A separate WHO summary edition exists and was not fetched.; snapshot `cardio:who-9789240033986-eng-pdf-2026-10-11` - Jurisdiction: Global WHO guidance; national adoption not recorded - Strength: Conditional recommendation, moderate-certainty evidence (GRADE. Section 2.5 of the WHO guideline (PDF page 17) says the guideline development group rated the certainty of evidence and developed the recommendations with the GRADE approach, and it defines a strong recommendation and a weak or conditional one.) - Effective: 2021-08-24 (The publication date on the WHO publication page.) - Supersession: Not checked - Applies to: Recipient: Adult; Population: Adults with hypertension who are at high risk, which WHO lists as high cardiovascular risk, diabetes mellitus or chronic kidney disease. WHO says the guideline targets non-pregnant adults.; Care setting: Not stated for this recommendation in the source; Geography: Global WHO guidance; national adoption not recorded; Life stage: Adult; Follow-up: Not applicable (recommendation context) - Basis: claim `cardio:claim-who-2021-r6c` ## Connected pages - NICE NG136 1.4.20: below 140/90 mmHg for adults under 80: Hypertension (high blood pressure) (`core:hypertension`) [a claim, not a settled fact; see claim `cardio:claim-nice-ng136-target-under-80` and its context] - WHO 2021 6a: below 140/90 mmHg without comorbidities (strong): Hypertension (high blood pressure) (`core:hypertension`) [a claim, not a settled fact; see claim `cardio:claim-who-2021-r6a` and its context] - WHO 2021 6b: systolic below 130 mmHg with cardiovascular disease (strong): Hypertension (high blood pressure) (`core:hypertension`) [a claim, not a settled fact; see claim `cardio:claim-who-2021-r6b` and its context] - WHO 2021 6c: systolic below 130 mmHg at high risk (conditional): Hypertension (high blood pressure) (`core:hypertension`) [a claim, not a settled fact; see claim `cardio:claim-who-2021-r6c` and its context] - Related to: Blood pressure lowering medicine (`cardio:bp-lowering-medicine`) - Has subtype: Intensive systolic blood-pressure lowering (target below 120 mm Hg) (`cardio:intensive-sbp-lowering`) ## Provenance Content hash: d33c9d683bed068fb711c5cecbb97b48466f27aa03f2ed47581a139eda082709 Last substantive edit: 2026-10-09 Evidence last checked: Not recorded