A first trace: the 120 mmHg systolic target

Introducing traces: full walk-throughs from a guideline sentence down to the data, indexed by condition.

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The first guideline trace is up: the 2017 ACC/AHA 120 mmHg systolic target, walked from the recommendation down to the blood-pressure measurement it rests on. Traces are now indexed by condition and ICD-10 code.
Published

June 9, 2026

The site now has traces: public walk-throughs that take one clinical recommendation and follow it down the pathway, rung by rung, from the guideline sentence to the raw measurement underneath it. They are indexed by condition and ICD-10 code, so a recommendation sits next to the disease it governs.

The first one is up, on hypertension.

What it traces. The 2017 ACC/AHA guideline lowered the systolic threshold that defines high blood pressure and set an intensive target near 120 mmHg, leaning heavily on the SPRINT trial. The catch sits on the bottom rung. SPRINT measured blood pressure with automated, rested, averaged readings, and those run lower than the single manual cuff most clinics still use. So the guideline number and the clinic number are not quite on the same scale, and a threshold validated under one method does not transfer cleanly to the other.

That is what a trace is for: to show where a confident recommendation is actually resting, and whether the rung underneath it can bear the weight a clinician puts there.

Read the 120 mmHg trace → · All traces by condition →

More are in progress, including tenecteplase versus alteplase in acute ischemic stroke. New traces are announced here, under the trace tag.