TY - JOUR T1 - Blood pressure-lowering treatment lowers mortality and cardiovascular disease risk, but whether effects differ at an arbitrary threshold of 140 mm Hg systolic blood pressure requires further research JF - BMJ Evidence-Based Medicine JO - BMJ EBM SP - 189 LP - 190 DO - 10.1136/bmjebm-2018-110934 VL - 23 IS - 5 AU - Dexter Canoy AU - Kazem Rahimi Y1 - 2018/10/01 UR - http://ebm.bmj.com/content/23/5/189.abstract N2 - 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 … ER -