Why the study?
The study was conducted to evaluate the effect of intensive SBP control in older adults with hypertension, considering cognitive and physical function.
Does intensive systolic blood pressure control to a target below 120 mm Hg reduce cardiovascular events, mortality, and cognitive impairment in adults aged 80 years or older with hypertension but without diabetes?
Population
1167 adults 80 years or older with hypertension without diabetes
Comparison
SBP target below 120 mm Hg vs below 140 mm Hg
Design
Secondary analysis of a randomized trial
Key result
Intensive SBP control reduced cardiovascular events (HR 0.66; 95% CI 0.49-0.90) and mortality in adults ≥80 years, though benefits were limited to those with higher baseline cognitive function.
Authors
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Supports intensive SBP targets in cognitively intact adults ≥80 years; extends SPRINT findings while identifying cognitive status as an effect modifier.
RCT (n=1,167)
randomized
Does intensive systolic blood pressure control to a target below 120 mm Hg reduce cardiovascular events, mortality, and cognitive impairment in adults aged 80 years or older with hypertension but without diabetes?
Hazard Ratio: 0.66 (95% CI 0.49–0.9)
Intensive blood pressure control (<120 mm Hg) in adults ≥80 years reduces cardiovascular events, mortality, and mild cognitive impairment, though benefits may be limited to those with higher baseline cognitive function and come with increased risk of kidney function decline.
Pajewski et al. (2019) conducted an RCT in hypertension (n=1,167). Intensive systolic blood pressure control vs. standard treatment (target below 140 mm Hg) was evaluated on cardiovascular events (HR 0.66, 95% CI 0.49-0.90). Intensive SBP control reduced cardiovascular events (HR 0.66; 95% CI 0.49-0.90) and mortality in adults ≥80 years, though benefits were limited to those with higher baseline cognitive function.