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Commentary on: Brunström M, Carlberg B. Association of blood pressure lowering with mortality and cardiovascular disease across blood pressure levels: a systematic review and meta-analysis. JAMA Intern Med 2018;178:28–36.
Favourable vascular health outcomes associated with blood pressure (BP)-lowering treatment are well-established. Using evidence from randomised controlled trials (RCTs), clinical guidelines support initiating treatment in patients with elevated BP usually set at systolic/diastolic BP ≥140/≥85 mm Hg. Over the years, increasing evidence suggests beneficial effects of BP-lowering treatment at baseline BP below these thresholds.1–3 However, in this current meta-analysis, methods used in earlier studies1 2 were questioned and aimed to re-examine differential effects of BP-lowering treatment on mortality and cardiovascular disease (CVD) by baseline systolic BP (SBP).4
This meta-analysis included BP-lowering treatment trials (vs placebo or each other with different BP targets) on all-cause mortality, CVD mortality, major cardiovascular events (MACE), coronary heart disease (CHD), stroke, heart failure and end-stage renal …
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