Key result
Intense blood pressure lowering to a target of < 120 mmHg remains unproven by conventional measurement methods due to conflicting evidence across major trials.
Why the study?
Does intense blood pressure lowering (target systolic blood pressure < 120 mmHg) improve outcomes in hypertensive patients compared to conventional targets?
Does intense blood pressure lowering (target systolic blood pressure < 120 mmHg) improve outcomes in hypertensive patients compared to conventional targets?
The review highlights that the benefit of a systolic blood pressure target < 120 mmHg remains unproven for conventional measurement methods, calling for individualized treatment goals.
Caution against <120 mmHg targets in routine care; leaves open need for standardized measurement trials.
The optimal target blood pressure (BP) in the treatment of hypertensive patients remains controversial. Recently, the systolic blood pressure trial (SPRINT) has proposed that a target systolic blood pressure of < 120 mmHg provides prognostic benefit in elderly hypertensive patients at high cardiovascular risk. The results of SPRINT contrast with several other intervention trials which have investigated the effect of intense BP lowering (Secondary Prevention of Small Subcortical Strokes [SPS3], Action to Control Cardiovascular Risk in Diabetes [ACCORD], Heart Outcomes Prevention Evaluation [HOPE]-3). The differences in outcomes in SPRINT vs. other intervention trials are, to a large extend, due to an "unobserved" BP measurement procedure utilized in the SPRINT trial. Thus, a BP goal of < 120 mmHg, at least by conventional BP measurement, remains unproven. Independent of SPRINT the controversial evidence with respect to BP targets calls for further studies and, possibly, for more individualized treatment goals.
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Rainer Düsing (2017) conducted a review in Hypertension. Intense blood pressure lowering (target < 120 mmHg) vs. Conventional blood pressure targets was evaluated. Intense blood pressure lowering to a target of < 120 mmHg remains unproven by conventional measurement methods due to conflicting evidence across major trials.
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