HealthDay News — According to a study published in the Journal of the American College of Cardiology, intensive blood pressure (BP) lowering strategies are associated with reduced risk of certain cardiovascular events for older patients with hypertension.

Chirag Bavishi, MD, MPH, from Mount Sinai St. Luke’s & Mount Sinai West Hospitals in New York City, and colleagues examined data from 4 high-quality trials involving 10,857 older hypertension patients (aged ≥65 years) with a mean follow-up of 3.1 years.

The researchers found that, compared with standard BP lowering, intensive BP lowering correlated with significant reductions in major adverse cardiovascular events (MACE), cardiovascular mortality and heart failure (pooled relative risks [RR], 0.71 [95% confidence interval (CI), 0.60 to 0.84], 0.67 [95% CI, 0.45 to 0.98] and 0.63 [95% CI, 0.43 to 0.99], respectively). 

There were no between-group differences in the rates of myocardial infarction or stroke. No significant between-group difference was seen in the incidence of serious adverse events or renal failure (RRs, 1.02 [95% CI, 0.94 to 1.09] and 1.81 [95% CI, 0.86 to 3.80], respectively).

In a fixed effects model, results were largely similar except the risk of renal failure was increased with intensive BP-lowering therapy (RR, 2.03 [95% CI, 1.30 to 3.18]).

“When considering intensive BP control, clinicians should carefully weigh benefits against potential risks,” the authors write.

Several authors disclosed financial ties to the pharmaceutical and medical technology industries.

References

Bavishi C, Bangalore S and Messerli FH. “Outcomes of Intensive Blood Pressure Lowering in Older Hypertensive Patients.” Journal of the American College of Cardiology. 2017. 69 (5): 486-493. doi: 10.1016/j.jacc.2016.10.077

Bakris G and Briasoulis A. “Searching for the Optimal Blood Pressure Range in the Elderly.” Journal of the American College of Cardiology. 2017. 69 (5): 494-496. doi: 10.1016/j.jacc.2016.10.076

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