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Optimal blood pressure control target for older patients with hypertension
![Evidence Network of Eligible Comparison for the Mixed Comparison Meta-Analysis. The cumulative number of enrolled studies for each direct comparison was indicated by the numbers by the lines. Credit: Cardiovascular Innovations and Applications (2023). DOI: 10.15212/CVIA.2023.0008 Optimal blood pressure control target for older patients with hypertension](https://scx1.b-cdn.net/csz/news/800a/2023/optimal-blood-pressure.jpg)
A new study published in the journal Cardiovascular Innovations and Applications evaluated the optimal systolic blood pressure (SBP) target for older patients with hypertension.
A Bayesian network meta-analysis was conducted. The risk of bias of the included studies was assessed by using a modified version of the Cochrane risk of bias. The trial outcomes comprised the following clinical events: major adverse cardiovascular events (MACE), cardiovascular mortality, all-cause mortality, myocardial infarction, heart failure and stroke.
A total of six trials were included. All treatment therapies were reclassified into three conditions according to the final achieved SBP after intervention (<130 mmHg, 130–139 mmHg and ≥140 mmHg). The results demonstrated that anti-hypertensive treatment with an SBP target <130 mmHg, compared with treatment with an SBP target ≥140 mmHg, significantly decreased the incidence of MACE (OR 0.43, 95%CI 0.19–0.76), but no statistical difference was found in other comparisons.
Although the results showed a trend toward more intensive anti-hypertension therapy having better effects on preventing cardiovascular mortality, all-cause mortality, myocardial infarction, heart failure, and stroke, no significant differences were found among groups.
The meta-analysis suggested that SBP <130 mmHg might be the optimal BP control target for patients ≥60 years of age; however, further evidence is required to support these findings.
More information: Yuling Yan et al, Optimal Blood Pressure Control Target for Older Patients with Hypertension: A Systematic Review and Meta-Analysis, Cardiovascular Innovations and Applications (2023). DOI: 10.15212/CVIA.2023.0008