Time to remove hypertension from our vocabulary?

Using the same methodological–analytical approach as in previous BPLTTC meta-analyses,2–5 the authors report similar relative reductions in major cardiovascular events from blood pressure lowering across a wide range of pre-treatment blood pressure levels, at least down to 120/70 mm Hg, within a wide range of age groups, up to 85 years and older. In 2002, the 1-million participant Prospective Studies Collaboration reported that the relative difference in risk of vascular mortality for a given difference in blood pressure was about the same across a blood pressure range from over 170/100 mm Hg down to at least 115/75 mm Hg.8 These findings suggested that the most meaningful definition of hypertension, for people aged 40–89 years, might be a blood pressure as low as 115/75 mm Hg—ie, the level above which risk of vascular disease increases monotonically with increasing blood pressure. [...]it is reassuring that all-cause mortality was not increased in treated people aged 85 years and older, supporting the common practice of continuing blood pressure-lowering treatment in these patients, unless other good reasons not to exist. Because most people aged 40 years and older have blood pressure levels above 115/75 mm Hg,9 almost all middle-aged and older people therefore have hypertension, making the term meaningless or implying that they should all be recommended for antihypertensive treatment.