Lowering Blood Pressure Associated with Reductions in Cardiovascular Events, Meta-Analysis Finds

By Kelly Young

Edited by Susan Sadoughi, MD, and André Sofair, MD, MPH

Reducing systolic blood pressure is associated with lower risk for cardiovascular events, suggests a meta-analysis in the Lancet.

Researchers analyzed the results of 123 trials involving over 600,000 patients who were randomized to specific BP targets, to different BP-lowering treatments, or to either BP-lowering drugs or placebo.

Each reduction in systolic blood pressure of 10 mm Hg was associated with significant reductions in major cardiovascular disease events (relative risk, 0.80), coronary heart disease (RR, 0.83), stroke (RR, 0.73), heart failure (RR, 0.72), and all-cause mortality (RR, 0.87). Benefits were observed even in patients with baseline systolic levels below 130 mm Hg and in those with comorbidities.

Dr. Harlan Krumholz, editor-in-chief of NEJM Journal Watch Cardiology, commented: "Systematic reviews of a vast number of very different studies can inform you about the state of the literature, but I think this one leaves a reader with a false sense of certainty about the evidence and how easily it can be combined to produce a tidy summary. In any case, what we need now are studies that help us personalize our approach for each individual and tools that provide guidance for the individual in front of us, given their clinical, social and personal characteristics."