Why the study?
While the benefits of reducing blood pressure are established, the optimal blood pressure level to maintain remains debatable.
Does intensive blood pressure control reduce major adverse cardiovascular events in patients with hypertension compared to standard blood pressure control?
Population
37,249 subjects from 12 randomized controlled trials
Comparison
Intensive blood pressure control vs standard blood pressure control
Design
Systematic review and meta-analysis of randomized controlled trials
Key result
Intensive blood pressure control reduced major adverse cardiovascular events by 20% (RR 0.80) compared to standard control, yielding an absolute risk reduction of 1.5%.
Authors
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Supports intensive targets with monitoring for hypotension and AKI; confirms consistent RCT evidence for lower BP goals.
Meta-Analysis (n=37,249)
Does intensive blood pressure control reduce major adverse cardiovascular events in patients with hypertension compared to standard blood pressure control?
Relative Risk: 0.8 (95% CI 0.73–0.88)
Absolute Risk Reduction: 1.5%
Number Needed to Treat: 67
p-value: p=<0.001
Intensive blood pressure control significantly reduces the risk of major adverse cardiovascular events but is associated with an increased risk of adverse events such as hypotension and acute kidney injury.
Rizwanullah et al. (2025) conducted a meta-analysis in Hypertension (n=37,249). Intensive blood pressure control vs. Standard blood pressure control (Target 140-150/90 mmHg) was evaluated on Major adverse cardiovascular events (MACE) composite including cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke (RR 0.80, 95% CI 0.73-0.88, p=<0.001). Intensive blood pressure control reduced major adverse cardiovascular events by 20% (RR 0.80) compared to standard control, yielding an absolute risk reduction of 1.5%.
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