Treatment to Lower BP Is Associated with Lower Mortality and Cardiovascular Risk When Systolic BP Is ≥140 mm Hg

High blood pressure (BP), particularly high systolic BP, is the strongest predictor of cardiovascular (CV)-related mortality, but the systolic BP level at which BP-lowering treatment should be initiated is somewhat controversial. In this meta-analysis, researchers examined data from 74 mostly industry-funded randomized trials in which pharmacologic treatment was compared with placebo, or different BP goals were compared with each other. Analysis involved about 306,000 participants and 1.2 million person-years of follow-up. Two thirds of the trials were classified as primary prevention (i.e., <50% of participants had known CV disease).

For primary prevention in patients with baseline systolic BPs of 140 to 159 mm Hg, treatment was associated …