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Therapeutics/Prevention
Randomised controlled trial
Intensive treatment of hypertension to a SBP <120 mm Hg in patients aged 75 and over reduces mortality and cardiovascular events
  1. Michael A Weber
  1. State University of New York Downstate Medical Center, Brooklyn, New York, USA
  1. Correspondence to: Professor Michael A Weber, State University of New York Downstate Medical Center, SUNY Downstate, Box 97, 450 Clarkson Avenue, Brooklyn, NY 11203, USA; michaelwebermd{at}cs.com
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http://dx.doi.org/10.1136/ebmed-2016-110536

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    Commentary on: Williamson JD, Supiano MA, Applegate WB, et al. Intensive vs standard blood pressure control and cardiovascular disease outcomes in adults aged ≥75 years. A randomized clinical trial. JAMA 2016;315:2673–82OpenUrlCrossRefPubMed.

    Context

    There is uncertainty regarding optimal blood pressure (BP) targets in treating hypertension. Most recent guidelines have recommended a systolic target of <140 mm Hg. The Systolic Blood Pressure Intervention Trial (SPRINT) compared cardiovascular (CV) outcomes in non-diabetic hypertensive patients randomised to standard (systolic blood pressure (SBP) <140 mm Hg) or intensive treatment (<120 mm Hg).1 Composite CV events and total mortality were significantly reduced with intensive treatment. A prespecified analysis evaluated older patients (≥75) and has now been published.

    Methods

    SPRINT compared outcomes with treatment targets of <120 mm Hg and <140 mm Hg in hypertensive patients at medium/high CV risk identified by previous CV events (except stroke), high Framingham risk …

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