Key result
BP-lowering raises peripheral arterial disease risk ~37% per 10 mmHg systolic reduction in cardiometabolic patients.
Why the study?
To evaluate the association between blood pressure reduction mediated by BP-lowering agents and the risk of peripheral arterial disease in patients with cardiometabolic risk factors.
Does intensive blood pressure reduction increase the risk of peripheral arterial disease in patients with cardiometabolic risk factors?
Meta-Analysis (n=94,482)
Does intensive blood pressure reduction increase the risk of peripheral arterial disease in patients with cardiometabolic risk factors?
Intensive reduction of systolic blood pressure using antihypertensive agents is associated with a dose-dependent increase in the risk of peripheral arterial disease, highlighting the need for gradual and moderate BP control in high-risk patients.
Intensive systolic blood pressure reduction may raise peripheral arterial disease risk; challenges assumptions favoring aggressive targets in cardiometabolic patients.
OBJECTIVE: To assess the association between the blood pressure (BP) reduction mediated by BP-lowering agents and the risks of peripheral arterial disease (PAD) in patients with cardiometabolic risk factors. METHODS: PubMed, EMBASE, the Cochrane Centre Register of Controlled Trials for Studies, the Scopus, Web of Science and Clinicaltrial.gov were searched from January 1980 to October 2023. Randomized controlled trials (RCTs) with statistically significant BP reduction in intensive BP-lowering treatments group compared with control treatment group, reporting the incidence of PAD were included. Regular and dose-response meta-analyses were both conducted. CONCLUSION: Our meta-analysis revealed that intensive reductions in SBP mediated by BP-lowering agents conferred increase the risk of PAD in patients with cardiometabolic risk factors. A gradual and moderate BP reduction as well as regular BP monitoring should be recommended for patients at high risk of PAD.
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Jiao et al. (2025) conducted a meta-analysis in Cardiometabolic risk factors requiring anti-hypertensive medications (n=94,482). Intensive blood pressure reduction vs. Control or standard blood pressure lowering treatment was evaluated on Risk of peripheral arterial disease (standardized per 10 mmHg reduction in systolic blood pressure) (RR 1.37, 95% CI 1.08 to 1.74). Each 10 mmHg reduction in systolic blood pressure mediated by blood pressure-lowering agents increased the risk of peripheral arterial disease by 37% (RR 1.37) in patients with cardiometabolic risk factors.
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