Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Which Target Blood Pressure in Year 2018? Evidence from Recent Clinical Trials

Heimark, Sondre ; Mariampillai, Julian E. ; Narkiewicz, Krzysztof ; Nilsson, Peter M. LU and Kjeldsen, Sverre E. (2018) In High Blood Pressure and Cardiovascular Prevention 25(2). p.151-158
Abstract

The Systolic Blood Pressure Intervention Trial (SPRINT) suggested a favourable effect of lowering blood pressure to < 120/80 mmHg in high-risk hypertensive patients; however, new American guidelines in 2017 have not followed SPRINT but lowered its recommended treatment target to < 130/80 mmHg. We aimed to review the latest research from large randomised controlled trials and observational analyses in order to investigate the evidence for new treatment targets. We assessed recent data from the Action to Control Cardiovascular Risk in Diabetes Blood Pressure (ACCORD) study, the International Verapamil-Trandolapril Study (INVEST), the Telmisartan, Ramipril or Both in Patients at High Risk for Vascular Events trial... (More)

The Systolic Blood Pressure Intervention Trial (SPRINT) suggested a favourable effect of lowering blood pressure to < 120/80 mmHg in high-risk hypertensive patients; however, new American guidelines in 2017 have not followed SPRINT but lowered its recommended treatment target to < 130/80 mmHg. We aimed to review the latest research from large randomised controlled trials and observational analyses in order to investigate the evidence for new treatment targets. We assessed recent data from the Action to Control Cardiovascular Risk in Diabetes Blood Pressure (ACCORD) study, the International Verapamil-Trandolapril Study (INVEST), the Telmisartan, Ramipril or Both in Patients at High Risk for Vascular Events trial (ONTARGET)/the Telmisartan Randomised AssessmenNt Study in aCE iNtolerant participants with cardiovascular Disease (TRANSCEND) study and The Losartan Intervention For Endpoint Reduction in Hypertension (LIFE) study. These studies confirm a positive effect on cardiovascular protection with blood pressure lowering treatment to between 120–140 mmHg in patients with and without diabetes, but no additional effect of lowering blood pressure to < 120 mmHg; possibly too aggressive treatment may increase both cardiovascular morbidity and mortality. Thus, a target blood pressure < 130/80 mmHg appears appropriate in most high-risk hypertensive patients. Additionally, early and sustained BP control below this target is required for optimal cardiovascular protection.

(Less)
Please use this url to cite or link to this publication:
author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Antihypertensive drug-treatment, Antihypertensive therapy, Blood pressure measurement, Blood pressure target, Cardiovascular disease, Hypertension, Randomized controlled trial
in
High Blood Pressure and Cardiovascular Prevention
volume
25
issue
2
pages
8 pages
publisher
Adis International
external identifiers
  • scopus:85048612347
  • pmid:29663195
ISSN
1120-9879
DOI
10.1007/s40292-018-0258-z
language
English
LU publication?
yes
id
6df3311f-fe43-486b-bfed-305ed287dc26
date added to LUP
2018-06-29 14:08:05
date last changed
2024-04-01 07:41:16
@article{6df3311f-fe43-486b-bfed-305ed287dc26,
  abstract     = {{<p>The Systolic Blood Pressure Intervention Trial (SPRINT) suggested a favourable effect of lowering blood pressure to &amp;lt; 120/80 mmHg in high-risk hypertensive patients; however, new American guidelines in 2017 have not followed SPRINT but lowered its recommended treatment target to &amp;lt; 130/80 mmHg. We aimed to review the latest research from large randomised controlled trials and observational analyses in order to investigate the evidence for new treatment targets. We assessed recent data from the Action to Control Cardiovascular Risk in Diabetes Blood Pressure (ACCORD) study, the International Verapamil-Trandolapril Study (INVEST), the Telmisartan, Ramipril or Both in Patients at High Risk for Vascular Events trial (ONTARGET)/the Telmisartan Randomised AssessmenNt Study in aCE iNtolerant participants with cardiovascular Disease (TRANSCEND) study and The Losartan Intervention For Endpoint Reduction in Hypertension (LIFE) study. These studies confirm a positive effect on cardiovascular protection with blood pressure lowering treatment to between 120–140 mmHg in patients with and without diabetes, but no additional effect of lowering blood pressure to &amp;lt; 120 mmHg; possibly too aggressive treatment may increase both cardiovascular morbidity and mortality. Thus, a target blood pressure &amp;lt; 130/80 mmHg appears appropriate in most high-risk hypertensive patients. Additionally, early and sustained BP control below this target is required for optimal cardiovascular protection.</p>}},
  author       = {{Heimark, Sondre and Mariampillai, Julian E. and Narkiewicz, Krzysztof and Nilsson, Peter M. and Kjeldsen, Sverre E.}},
  issn         = {{1120-9879}},
  keywords     = {{Antihypertensive drug-treatment; Antihypertensive therapy; Blood pressure measurement; Blood pressure target; Cardiovascular disease; Hypertension; Randomized controlled trial}},
  language     = {{eng}},
  month        = {{06}},
  number       = {{2}},
  pages        = {{151--158}},
  publisher    = {{Adis International}},
  series       = {{High Blood Pressure and Cardiovascular Prevention}},
  title        = {{Which Target Blood Pressure in Year 2018? Evidence from Recent Clinical Trials}},
  url          = {{http://dx.doi.org/10.1007/s40292-018-0258-z}},
  doi          = {{10.1007/s40292-018-0258-z}},
  volume       = {{25}},
  year         = {{2018}},
}