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Retrospective cohort study assessing cardiovascular risk reduction through intensive blood pressure management in

Baihui Tang1, Wenxi Gu1

  • 1Department of Cardiology, Affiliated Chongming Hospital of Shanghai University of Medicine & Health Sciences, Shanghai, China.

Frontiers in Cardiovascular Medicine
|July 2, 2026
PubMed

Insights

Lowering systolic blood pressure (SBP) in high-risk patients significantly reduces major adverse cardiovascular events (MACE). This supports further research into optimal SBP targets, particularly for those with diabetes and chronic kidney disease.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Public Health

Background:

  • Hypertension is a primary global risk factor for cardiovascular disease.
  • Lowering systolic blood pressure (SBP) is clinically recommended to reduce cardiovascular risk.
  • Real-world data on SBP targets in high-risk populations are limited.

Purpose of the Study:

  • To evaluate the association between achieved SBP levels and cardiovascular outcomes in high-risk hypertensive patients.
  • To assess the impact of lower SBP targets on major adverse cardiovascular events (MACE).
  • To identify patient subgroups benefiting most from intensive SBP control.

Main Methods:

  • Retrospective cohort study of 180 high-risk hypertensive patients (Jan 2022-Dec 2024).
  • Patients categorized by achieved SBP: <120 mmHg vs. 130-139 mmHg.
  • Primary endpoint: composite MACE (myocardial infarction, stroke, heart failure, cardiovascular death/hospitalization).

Main Results:

  • Lower achieved SBP (<120 mmHg) group showed significantly fewer MACE events (14.8% vs. 26.5%, p=0.03) over 18 months.
  • Significant benefits observed in patients with diabetes and chronic kidney disease (30% relative risk reduction).
  • Benefits were attenuated in elderly patients (>75 years); adverse events were manageable.

Conclusions:

  • Lower achieved SBP levels are associated with reduced cardiovascular event rates in high-risk hypertensive individuals.
  • Findings support further prospective studies to define optimal BP targets.
  • Particular attention to SBP targets is warranted for patients with diabetes and chronic kidney disease.
Abstract

Keywords:
cardiovascular risk reductionchronic kidney diseasediabeteshigh-risk patientshypertensionintensive blood pressure managementretrospective cohort study

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