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BP target is no illusion, it needs commitment

I am a little disappointed by Dr Nicholas Down's claim (Letters, October 6) that the achievement of blood pressure of 150/90 is an illusion and dispute that this target is unattainable.

What, I think, he demonstrates is a lack of enthusiasm. A series of readings will give a reasonable mean and treatment is available for those who need it. If carefully followed up, treatment will be successful in most cases. Herein lies the problem ­ not the target, but the commitment.

There are probably 17 million patients in the UK with raised blood pressure and probably half are unidentified.

We know that treatment will improve a patient's life expectancy and that every millimetre matters1. Furthermore we know that to reduce a blood pressure by even a moderate amount will have far-reaching and long-lasting benefits2.

A reduction in mean blood pressure of only

5-6mmHg gives a 40 per cent reduction in stroke and a 25 per cent reduction in CHD. These benefits affect not only the patient but ultimately the NHS budget, both local and national.

I hope Dr Down will persevere because achieving this single performance target will have enormous benefits for his patients.

Dr Peter Tooley


1. Lancet 1998; 351: 1755-62 2. Lancet 1990; 335: 827-38

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