- Low vs standard BP targets “probably” make little to no difference in mortality outcomes for patients with hypertension and cardiovascular disease (CVD), say these Cochrane review authors.
- The results suggest that a lower systolic BP target offers “no net health benefit,” they say.
Why this matters
- These authors looked at outcomes based on 135/85 mmHg BP targets vs standard targets (140-160/90-100 mmHg).
- Controversy about the lower targets has persisted since the results of SPRINT.
- 6 randomized controlled trials included, with a total of 9484 participants.
- Total mortality with low vs standard targets: risk ratio, 1.06 (95% CI, 0.91-1.23; moderate-quality evidence).
- Cardiovascular mortality: 1.03 (95% CI, 0.82-1.29; moderate-quality evidence).
- Serious adverse event rates also did not differ, and neither did total cardiovascular events (low-quality evidence for both).
- The results suggest more participants dropped out of studies with lower targets (risk ratio, 8.16; 95% CI, 2.06-32.28; 2 studies, n=690; very low-quality evidence).
- The lower-target group did achieve lower BP values but also needed more drugs.
- Updated Cochrane review, including trial data up to November 2019.
- Funding: Navarre Health Service, Spain; European Social Fund Operational Programme; others.
- Some data were imputed.
- Heterogeneity among trials.