Optimal blood pressure control target for older patients with hypertension

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.