An 83-year-old man with type 2 diabetes has clinic BP 142/88 mmHg. What is the most appropriate clinic BP target according to NICE guidelines?

• A. 140/90 mmHg
• B. 150/90 mmHg
• C. 130/80 mmHg
• D. 160/95 mmHg

Answer: (B)

In NICE guidelines, blood pressure targets are tailored to age and comorbidity. For adults aged 80 years or older, the clinic blood pressure target is below 150/90 mmHg. This relaxed goal helps reduce the risk of adverse effects like dizziness or falls that can come with overly aggressive lowering in the elderly, especially when other conditions such as diabetes are present.

Here, the patient is 83 with type 2 diabetes, so the appropriate clinic BP target is 150/90 mmHg or lower. His current clinic reading is 142/88 mmHg, which already meets that target, so no escalation is indicated based on this measurement alone. Lower targets (like 140/90 or 130/80) are more commonly aimed for in younger patients or those with fewer frailties, but are not the standard target in this older, high-risk group.