More Evidence to Support Aggressive BP Lowering in High-Risk Patients

The SPRINT study showed better cardiovascular (CV) outcomes in high-risk nondiabetic patients who received antihypertensive treatment to systolic blood pressure (BP) targets of 120 mm Hg rather than 140 mm Hg (NEJM JW Gen Med Dec 15 2015 and N Engl J Med 2015; 373:2103) — a finding that has challenged recent guidelines calling for more-relaxed BP targets in high-risk patients. Now, investigators report on a meta-analysis of 123 randomized trials in which CV outcomes were assessed in >600,000 patients who received antihypertensive medication versus placebo or one antihypertensive medication versus another, or were treated to attain different BP targets. No trials were excluded because of baseline comorbidities.

Findings included the following…