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May 12, 2023European Journal of Preventive CardiologyOpen Access

Intensive SBP control cuts cardiovascular risk ~39% versus standard treatment.

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Why the study?

Intensive systolic blood pressure lowering is increasingly used, but data are missing on patients who achieve their target blood pressure.

Does achieving an intensive SBP target (110 to <130 mmHg) reduce cardiovascular events compared to achieving a standard SBP target (130 to <150 mmHg) in hypertensive patients aged 60-80 years?

Population

8511 hypertensive patients aged 60-80 years without prior stroke

Comparison

Intensive treatment (SBP target 110 to <130 mmHg) vs standard treatment (130 to <150 mmHg)

Design

Secondary analysis of a multicentre randomized controlled trial

Follow-up

Median 3.38-year

Key result

Maintaining systolic blood pressure at intensive levels (<130 mmHg) significantly lowered cardiovascular risk compared to standard treatment (HR 0.61; 95% CI 0.46-0.80; P<0.001).

Authors

YDYue DengJBJingjing BaiXYXinchun Yang

Discussion

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Overview

Supports intensive SBP targets (<130 mmHg) in hypertensives aged 60-80; reinforces benefits from prior randomized trials.

Study Design

Type

RCT (n=8,511)

Multicenter

Yes

Structured PICO

Does achieving an intensive SBP target (110 to <130 mmHg) reduce cardiovascular events compared to achieving a standard SBP target (130 to <150 mmHg) in hypertensive patients aged 60-80 years?

P
Population
8,511 young-older (60-80 years) hypertensive patients without prior stroke. This secondary analysis included 6,480 patients who achieved their SBP targets.
I
Intervention
Intensive blood pressure treatment (SBP target 110 to <130 mmHg) with target achieved (mean follow-up SBP 124.2 mmHg)
C
Comparator
Standard blood pressure treatment (SBP target 130 to <150 mmHg) with target achieved (mean follow-up SBP 137.4 mmHg)
O
Outcome
Cardiovascular eventscomposite

Main Result

Effect estimate: HR 0.61 (95% CI 0.46-0.80)

p-value: p=< 0.001

Achieving and maintaining an intensive SBP target of <130 mmHg provides significant cardiovascular benefits over standard targets in older hypertensive patients.

Cite This Study

Deng et al. (2023) conducted an RCT in Hypertension (n=8,511). Intensive SBP lowering (target 110 to <130 mmHg) vs. Standard SBP lowering (target 130 to <150 mmHg) was evaluated on Cardiovascular events (HR 0.61, 95% CI 0.46-0.80, p=< 0.001). Maintaining systolic blood pressure at intensive levels (<130 mmHg) significantly lowered cardiovascular risk compared to standard treatment (HR 0.61; 95% CI 0.46-0.80; P<0.001).

synapsesocial.com/papers/6a18100e56b3e2ada412e22fhttps://doi.org/10.1093/eurjpc/zwad142
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