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How low can you go? Achieved blood pressure and cardiovascular outcomes

Christina M Wyatt1, Alfred K Cheung2

  • 1Department of Medicine, Division of Nephrology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.

Kidney International
|August 16, 2017
PubMed

Insights

Lowering blood pressure below 120/70 mm Hg may not offer additional benefits and could increase cardiovascular risks. Further research is needed to determine optimal blood pressure targets for high-risk patients.

Area of Science:

  • Cardiology
  • Hypertension Management
  • Clinical Trials

Background:

  • Established benefits of blood pressure control below 140/90 mm Hg.
  • Uncertainty regarding risks and benefits of further blood pressure reduction.

Purpose of the Study:

  • To investigate the cardiovascular risks and benefits of achieving lower blood pressure targets.
  • To contribute to the debate on optimal blood pressure targets for high-risk individuals.

Main Methods:

  • Analysis of pooled data from two large randomized trials.
  • Focus on renin-angiotensin system blockers.
  • Observational study design.

Main Results:

  • No additional cardiovascular benefit observed with systolic blood pressure < 120 mm Hg or diastolic blood pressure < 70 mm Hg.
  • Potential increased risk of cardiovascular events at these lower blood pressure levels.

Conclusions:

  • Current evidence suggests caution when aiming for very low blood pressure targets.
  • The optimal blood pressure target for high-risk individuals remains a subject of ongoing controversy.

Keywords:
cardiovascular diseasecongestive heart failure

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