Key result
Lower BP targets fail to reduce total mortality versus standard targets in hypertension and CVD.
Why the study?
Reducing blood pressure below standard targets in patients with hypertension and established cardiovascular disease might reduce morbidity and mortality but could increase adverse events; the optimal target remains unknown.
Do lower blood pressure targets (≤135/85 mmHg) reduce mortality and morbidity compared to standard targets in adults with hypertension and established cardiovascular disease?
Population
9595 participants with hypertension and established cardiovascular disease across seven RCTs
Comparison
Lower blood pressure targets (135/85 mmHg or less) vs standard targets (140 to 160/90 to 100 mmHg or less)
Design
Systematic review and meta-analysis of RCTs
Follow-up
Mean 3.7 years (range 1.0 to 4.7 years)
Authors
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No mortality benefit from lower BP targets in hypertensive CVD; confirms standard targets suffice without added survival gain.
Do lower blood pressure targets (≤135/85 mmHg) reduce mortality and morbidity compared to standard targets in adults with hypertension and established cardiovascular disease?
In patients with hypertension and established cardiovascular disease, targeting a lower blood pressure (≤135/85 mmHg) does not improve survival or reduce cardiovascular events compared to standard targets, but may increase adverse effects.
Saiz et al. (2022) studied this question. Lower blood pressure targets (≤135/85 mmHg) did not reduce total mortality (RR 1.05, 95% CI 0.91-1.23) compared to standard targets in patients with hypertension and cardiovascular disease.
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