An analysis of the electronic health records of nearly 400,000 people reveals that aggressive treatment of hypertension may create unintended kidney disease and even death.

Researchers examined the EHRs of Kaiser Permanente patients in southern California who were taking medications to treat high blood pressure from January 2006 through December 2010. They found that:

*Patients within the range between 130 and 139 systolic and between 60 and 79 diastolic blood pressure were at the lowest risk for kidney failure and death. Those who achieved a blood pressure outside of that range, either above or below, were more likely to have increased health risks.

*Patients who had a systolic blood pressure in the range between 120 and 129 (widely accepted as normal) were 10 percent more likely than those who had a systolic blood pressure between 130 and 139 to die or develop kidney failure.

*Patients who had a systolic blood pressure between 140 and 149 were 40 percent more likely than those who had a systolic rate between 130 and 139 to die or develop kidney failure.

“Physicians have often emphasized the need to bring a patient’s blood pressure down as low as possible for the best outcomes,” said lead study author John J. Sim, M.D., Kaiser Permanente Los Angeles Medical Center. “However, the findings of our study suggest that treating patients with high blood pressure too aggressively may potentially lead to poor health outcomes.”

Kaiser executives said the results of this study also demonstrate a need to better understand the ideal target blood pressure ranges as well as the potential dangers of over-treating patients, according to the researchers.

“We hope our findings will pave the way for a more effective strategy in treating high blood pressure,” said Sim. “Through personalized treatment plans, we can minimize the lifestyle burden on patients and improve the safety of their treatment regimens, while reducing the cost to both patients and the healthcare system as a whole.”

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