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Effect of intensive versus standard blood pressure control on cardiovascular outcomes: a meta-analysis of randomized

Qiu Gao1, Yanni Ji1

  • 1Department of Cardiology, Yixing People's Hospital, Yixing, Jiangsu Province, China.

Annals of Medicine
|April 30, 2026
PubMed

Insights

Intensive blood pressure control significantly lowers cardiovascular risks, including heart attack and stroke. These findings support lower blood pressure targets for improved patient outcomes in hypertension management.

Area of Science:

  • Cardiology
  • Public Health
  • Clinical Trials

Background:

  • Hypertension management strategies vary, with differing targets for blood pressure control.
  • The impact of intensive versus standard blood pressure control on cardiovascular outcomes requires systematic evaluation.

Purpose of the Study:

  • To systematically evaluate the impact of intensive versus standard blood pressure control on cardiovascular outcomes.
  • To synthesize evidence from randomized controlled trials (RCTs) to inform clinical practice guidelines.

Main Methods:

  • A comprehensive meta-analysis of RCTs was conducted, searching major databases up to May 2025.
  • Thirty-one RCTs with 156,933 participants were included, using a random-effects model for pooled risk estimates.

Main Results:

  • Intensive blood pressure control significantly reduced major cardiovascular events (RR: 0.80), myocardial infarction (RR: 0.83), stroke (RR: 0.76), all-cause mortality (RR: 0.87), and cardiac death (RR: 0.79).
  • Sensitivity analyses confirmed the robustness of these findings.
  • Treatment effects showed variability based on participant characteristics and study duration.

Conclusions:

  • Intensive blood pressure control, targeting systolic BP <120 or <130 mmHg, is associated with substantially reduced cardiovascular event risk.
  • These results advocate for the adoption of lower blood pressure targets in clinical practice.
  • Individualized patient assessment is crucial when implementing intensive blood pressure control strategies.
Abstract

Keywords:
Hypertensionblood pressurecardiovascular outcomesmeta-analysis

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