Key result
Targeting a systolic blood pressure of <120 mm Hg reduced the composite cardiovascular outcome by 25% and all-cause mortality by 27% compared to a target of <140 mm Hg in high-risk nondiabetic patients.
Why the study?
Does aggressive blood pressure lowering reduce cardiovascular events and mortality in adults with hypertension compared to standard targets?
Population
Adults with hypertension or at risk for cardiovascular events
Comparison
Aggressive blood pressure lowering vs Standard blood pressure lowering
Design
Review
Authors
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Supports intensive BP targets in high-risk nondiabetics; leaves open optimal thresholds and safety in broader groups.
Does aggressive blood pressure lowering reduce cardiovascular events and mortality in adults with hypertension compared to standard targets?
Effect estimate: RR 0.75
The shift towards lower blood pressure targets in hypertension guidelines emphasizes the need for individualized treatment strategies and shared decision-making to optimize cardiovascular outcomes while minimizing adverse events.
Robert D. Toto (2018) conducted a review in Hypertension (n=9,361). Intensive blood pressure lowering vs. Target systolic BP <140 mm Hg was evaluated on Composite of myocardial infarction, acute coronary syndrome, stroke, acute decompensated heart failure, and cardiovascular disease death (RR 0.75). Targeting a systolic blood pressure of <120 mm Hg reduced the composite cardiovascular outcome by 25% and all-cause mortality by 27% compared to a target of <140 mm Hg in high-risk nondiabetic patients.
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