Key result
Intensive blood pressure lowering to a systolic target of <130 mm Hg in adults aged 60 years or older is safe and reduces cardiovascular events, stroke, and all-cause mortality.
Why the study?
Does intensive blood pressure control (target SBP <130 mm Hg) reduce cardiovascular events, stroke, and all-cause mortality in adults aged 60 years or older with hypertension?
Does intensive blood pressure control (target SBP <130 mm Hg) reduce cardiovascular events, stroke, and all-cause mortality in adults aged 60 years or older with hypertension?
Intensive blood pressure control (target SBP <130 mm Hg) in older adults is safe and reduces cardiovascular events, supporting the updated Chinese hypertension guidelines.
In November 2022, the Clinical Practice Guidelines for the Management of Hypertension in China were updated; the definition of hypertension and the target of treatment was changed from 140/90 mm Hg to 130/80 mm Hg. This was prompted by the results of the Strategy of Blood Pressure Intervention in the Elderly Hypertensive Patients (STEP) study, a large multicenter randomized controlled trial conducted in China. STEP echoed the results of the American Systolic Blood Pressure Intervention Trial (SPRINT), and confirmed that intense lowering of blood pressure is on the whole beneficial. This confirmation is important for the Chinese population, in which strokes outnumber myocardial infarctions. It is also reassuring to know that treating adults aged 60 years or older to achieve a systolic blood pressure of <130 mm Hg is safe, while reducing cardiovascular events, stroke and all-cause mortality. Nevertheless, further studies are needed to delineate the risks and benefits in subgroups, such as the elderly with diabetes or a history of stroke.
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Liang et al. (2023) conducted an editorial in Hypertension. Intensive blood pressure control (target <130 mm Hg) vs. Standard blood pressure control (target <140/90 mm Hg) was evaluated on Cardiovascular events, stroke and all-cause mortality. Intensive blood pressure lowering to a systolic target of <130 mm Hg in adults aged 60 years or older is safe and reduces cardiovascular events, stroke, and all-cause mortality.
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