Primary preventive blood pressure lowering in the 130-140 mmHg systolic blood pressure (SBP) range adds no cardiovascular benefit, but increases the risk of adverse events, according to a review and meta-analysis published in BMJ Open this week.
For the study, researchers examined data from 18 randomised placebo-controlled trials incorporating 92,567 participants, to assess the effect of antihypertensive treatment on outcomes in the 130-140 mmHg SBP range.
The authors reported that primary preventive antihypertensive treatment was associated with a neutral effect on all-cause mortality (relative risk [RR] 1.00; 95% CI 0.95-1.06) and major cardiovascular events (RR 1.01; 95% CI 0.96-1.06). However, they noted it had an increased risk of adverse events leading to discontinuation (RR 1.23; 95% CI 1.03-1.47).
In coronary artery disease (CAD) secondary prevention, antihypertensive treatment was associated with reduced risk of all-cause mortality and major cardiovascular events, but a more than two-fold increased risk of adverse events leading to discontinuation.
The authors said that overall, the results do not support antihypertensive treatment in the 130-140 mm Hg SBP interval, except for in patients with established CAD, adding that even in this group, “benefits should be balanced against potential harms for individual patients".