Should Blood Pressure Targets Differ for Frail and Nonfrail Adults?

Outcomes of many studies have demonstrated the benefits of intensive control of blood pressure (BP), but few have specifically assessed target BPs in adults with frailty. Accordingly, hypertension guidelines give only vague recommendations for BP management in such patients. To clarify BP targets in frail patients, researchers conducted a post hoc analysis of the ESPRIT randomized trial, in which intensive BP control (systolic BP <120 mm Hg) significantly lowered likelihood of major adverse cardiovascular events relative to standard BP control (systolic BP <140 mm Hg). The 11,000 participants (mean age, 65; all at excess cardiovascular risk) were categorized as nonfrail (39%), moderately frail (47%), or severely frail (14%).