Intensive Blood Pressure Lowering in Older People with Hypertension: A Time-to-Benefit Analysis

Randomized trials have shown that intensive blood pressure (BP) control lowers risk for major adverse cardiovascular events (MACEs) in older adults. However, intensive BP control can cause adverse events (e.g., hypotension, syncope, falls, kidney injury, electrolyte disturbance). In this meta-analysis of six randomized clinical trials that involved 27,400 participants (age, ≥60; mean age, 70) with hypertension, researchers estimated the time to benefit of intensive BP lowering.

Intensive BP lowering (defined by these authors as lowering systolic BP <140 mm Hg) was associated with a significant 21% lower relative risk for MACEs. Five hundred patients with hypertension would need intensive BP-lowering treatment for 9 months to prevent one MACE…