Benefits for intensive BP lowering in older HTN patients

(HealthDay)—For older patients with hypertension, intensive blood pressure (BP) lowering strategies are associated with reduced risk of certain cardiovascular events, according to research published in the Feb. 7 issue of the Journal of the American College of Cardiology.

Chirag Bavishi, M.D., M.P.H., from Mount Sinai St. Luke's & Mount Sinai West Hospitals in New York City, and colleagues examined data from four high-quality trials involving 10,857 older hypertension patients (aged ≥65 years) with a mean follow-up of 3.1 years.

The researchers found that, compared with standard BP lowering, intensive BP lowering correlated with significant reductions in major adverse cardiovascular events (MACE), cardiovascular mortality, and heart failure (pooled relative risks [RR], 0.71 [95 percent confidence interval (CI), 0.60 to 0.84], 0.67 [95 percent CI, 0.45 to 0.98], and 0.63 [95 percent CI, 0.43 to 0.99], respectively). There were no between-group differences in the rates of myocardial infarction or stroke. No significant between-group difference was seen in the incidence of serious adverse events or renal failure (RRs, 1.02 [95 percent CI, 0.94 to 1.09] and 1.81 [95 percent CI, 0.86 to 3.80], respectively). In a fixed effects model, results were largely similar except the risk of renal failure was increased with intensive BP-lowering therapy (RR, 2.03 [95 percent CI, 1.30 to 3.18]).

"When considering intensive BP control, clinicians should carefully weigh benefits against potential risks," the authors write.

Several authors disclosed financial ties to the pharmaceutical and medical technology industries.