Journal of hypertension
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Journal of hypertension · Nov 2017
Meta AnalysisEffects of blood-pressure-lowering treatment on outcome incidence in hypertension. 11. Effects of total cardiovascular risk and achieved blood pressure: overview and meta-analyses of randomized trials.
In recent meta-analyses of blood pressure (BP)-lowering randomized controlled trials (RCTs), we have shown that in hypertensive patients with diabetes, but not in those without, relative risk reduction of cardiovascular outcomes for a standardized BP reduction is significantly smaller at progressively lower SBP values achieved by treatment. ⋯ A high level of cardiovascular risk is not in itself a restraint to target at SBP values less than 130 mmHg, if treatment is well tolerated. Though a high cardiovascular risk associated with diabetes is not an indication for aiming at SBP less than 130 mmHg, current evidence is that SBP values slightly below 130 mmHg are not associated with harm.