A new review of 22,000 people being treated for high blood pressure reveals absolutely no benefit for using medication to lower blood pressure below 140/90.  Over the past several years "experts" with ties to industry have created "expert panels" to recommend lower and lower guidelines for when to use blood pressure medications.  Amazingly, these recommendations have not been supported by evidence, yet have been unquestioned by most doctors.  This new review came to the following conclusions (the following is quoted from this medscape link):

"We found there is no evidence that reaching a target of below 90 mm Hg diastolic BP will provide additional clinical benefit, but we can't say whether lowering systolic BP below 140 mm Hg will be beneficial or not; there are no data."

Dr Franz Messerli (St Luke Roosevelt Hospital, New York, NY), who was not involved with this review, told heartwire that there is no question that the 140/90-mm-Hg BP limit is "absolutely arbitrary, and the benefits of antihypertensive medications are most obvious in patients with the highest BP. The closer we get to 'normotension,' the more difficult it becomes to show benefits of BP lowering.

"This strategy did not prolong survival or reduce stroke, heart attack, heart failure, or kidney failure," they note. "More trials are needed, but at present there is no evidence to support aiming for a blood-pressure target lower than 140/90 mm Hg in any hypertensive patient."

The take-home from this review is two-fold: first, if your blood pressure is under 140/90 without medication, don't medicate!  Second, don't believe expert panels unless there is evidence--too often we have recommendations that are based on what is profitable to drug companies rather then what benefits the patient.

Link to the MedScape commentary.