Key result
Lower BP targets fail to reduce total mortality vs standard targets in hypertension and CVD.
Why the study?
Does a lower blood pressure target (≤ 135/85 mmHg) reduce mortality and morbidity compared to a standard target (≤ 140 to 160/90 to 100 mmHg) in adults with hypertension and established cardiovascular disease?
Population
9,795 adults with documented hypertension and established cardiovascular disease pooled from 6 RCTs.
Comparison
Lower blood pressure target (≤ 135/85 mmHg) vs Standard blood pressure target
Design
Meta-analysis
Follow-up
Mean 3.7 years (range 1.0 to 4.7 years)
Authors
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Lower targets yield no mortality benefit in hypertensive CVD patients; reinforces standard targets to limit adverse-effect withdrawals.
Meta-Analysis (n=9,795)
Does a lower blood pressure target (≤ 135/85 mmHg) reduce mortality and morbidity compared to a standard target (≤ 140 to 160/90 to 100 mmHg) in adults with hypertension and established cardiovascular disease?
Effect estimate: RR 1.05 (95% CI 0.90-1.22)
In patients with hypertension and established cardiovascular disease, targeting a lower blood pressure (≤ 135/85 mmHg) does not reduce total mortality or serious adverse events compared to a standard target.
Saiz et al. (2017) conducted a meta-analysis in Hypertension and cardiovascular disease (n=9,795). Lower blood pressure target vs. Standard blood pressure target (≤ 140 to 160/90 to 100 mmHg) was evaluated on Total mortality (RR 1.05, 95% CI 0.90-1.22). Treating to a lower blood pressure target (≤ 135/85 mmHg) did not significantly reduce total mortality compared to standard targets in patients with hypertension and CVD (RR 1.05; 95% CI 0.90-1.22).
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