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Published on: May 3, 2018
Effects of blood pressure goals on cardiovascular outcomes in hypertensive patients
Zonglei Du1, Weishi Bian2, Shanxia Wu2
1Department of Cardiovascular Medicine, Zouchen People's Hospital, Zouchen, China.
Insights
Achieving lower blood pressure (BP) goals in hypertensive patients is linked to better cardiovascular outcomes compared to uncontrolled hypertension. A low BP goal (< 130/80 mm Hg) shows superior results over a high BP goal (< 140/90 mm Hg).
Area of Science:
- Cardiology
- Nephrology
- Public Health
Background:
- Hypertension management is crucial for preventing cardiovascular events.
- Defining optimal blood pressure (BP) targets remains an area of active research.
- Understanding the impact of different BP goals on patient outcomes is essential.
Purpose of the Study:
- To evaluate the association between therapeutic blood pressure (BP) goals and cardiovascular outcomes in hypertensive patients.
- To compare cardiovascular event rates across different BP goal categories: low (< 130/80 mm Hg), high (< 140/90 mm Hg), and uncontrolled (≥ 140/90 mm Hg).
Main Methods:
- Retrospective analysis of 1226 primary hypertensive patients from outpatient clinics.
- Data collection included demographics, comorbidities, laboratory parameters, and glomerular filtration rate (GFR).
- Patients were followed for 1 year, with cardiovascular outcomes including mortality, myocardial infarction, and stroke/transient ischemic attack.
Main Results:
- The uncontrolled hypertension group exhibited higher rates of composite cardiovascular endpoints compared to both low and high therapeutic goal groups.
- Patients in the uncontrolled group were older, had more comorbidities like diabetes, lower GFR, and a history of stroke.
- After adjusting for confounders, uncontrolled hypertension significantly increased the risk of composite endpoints, with benefits more pronounced in the low BP goal group.
Conclusions:
- Lowering blood pressure (BP) goals in hypertensive patients is associated with improved cardiovascular outcomes.
- A low therapeutic BP goal (< 130/80 mm Hg) demonstrates superior cardiovascular protection compared to a high therapeutic BP goal (< 140/90 mm Hg).
- These findings support the implementation of stricter BP control targets for hypertensive individuals to reduce cardiovascular risk.
Introduction:
The aim of the study was to evaluate the effects of blood pressure (BP) goals on cardiovascular outcomes in hypertensive patients.
Material And Methods:
Primary hypertensive patients were retrospectively enrolled from outpatient clinics. The demographics, comorbidities, laboratory parameters and glomerular filtration rate (GFR) were collected. All participants were followed for 1 year. Cardiovascular outcomes included composite of all-cause mortality, non-fatal myocardial infarction, and non-fatal ischemic stroke/transient ischemic attack. Adverse event was defined as falling down and GFR decrease at follow-up.
Results:
A total of 1226 patients were included. Based on therapeutic BP goals, participants were divided into low (< 130/80 mm Hg) and high (< 140/90 mm Hg) therapeutic goal groups and an uncontrolled hypertension (≥ 140/90 mm Hg) group. Compared to the low therapeutic goal group, patients in the uncontrolled group were older and more likely to be smokers, have longer duration of hypertension, diabetes mellitus, lower GFR and higher prevalent ischemic stroke (p < 0.05). Patients in the uncontrolled hypertension group had higher incidence of composite endpoints than low and high therapeutic goal groups. Two cases of falling down were observed in the low therapeutic goal group and no significant changes in GFR were observed. With adjustment for confounding factors, the uncontrolled hypertension group had higher risk of composite endpoints compared to low and high therapeutic goal groups, and these benefits were more prominent in the low versus high therapeutic goal group.
Conclusions:
In hypertension patients, when compared to uncontrolled hypertension patients, low therapeutic BP goal is associated with better cardiovascular outcomes than high therapeutic BP goal.
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