Effects of intensive blood pressure lowering on cardiovascular and renal outcomes: updated systematic review and meta-analysis

@article{Xie2016EffectsOI,
  title={Effects of intensive blood pressure lowering on cardiovascular and renal outcomes: updated systematic review and meta-analysis},
  author={Xinfang Xie and Emily R Atkins and Ji‐cheng Lv and Alexander Bennett and Bruce Neal and Toshiharu Ninomiya and Mark Woodward and Stephen MacMahon and Fiona M Turnbull and Graham S. Hillis and John Chalmers and Jonathan Mant and Abdul Salam and Kazem Rahimi and Vlado Perkovic and Anthony Rodgers},
  journal={The Lancet},
  year={2016},
  volume={387},
  pages={435-443}
}
Effects of intensive blood pressure lowering on mortality and cardiovascular and renal outcomes in type 2 diabetic patients: A meta-analysis
TLDR
It is indicated that intensive BP lowering treatment provides greater benefits than less intensive treatment among patients with type 2 diabetes mellitus, and further studies are required to more clearly evaluate the benefits and harms of BP targets below those currently recommended with intensive BP lowered treatment.
Optimal blood pressure targets for patients with hypertension: a systematic review and meta-analysis
TLDR
A target BP level of < 130/80 mm Hg appears to be optimal for CV protection in patients with hypertension, and subgroup analyses indicated that intensive BP-lowering treatment with a target of‪‬<‬130/ 80”mm”Hg and/or achievement of BP were associated with a significant reduction in major CV events compared with the usual group.
Blood pressure-lowering treatment lowers mortality and cardiovascular disease risk, but whether effects differ at an arbitrary threshold of 140 mm Hg systolic blood pressure requires further research
Commentary on: Brunstrom M, Carlberg B. Association of blood pressure lowering with mortality and cardiovascular disease across blood pressure levels: a systematic review and meta-analysis. JAMA
Effect of antihypertensive treatment at different blood pressure levels in patients with diabetes mellitus: systematic review and meta-analyses
TLDR
Antihypertensive treatment reduces the risk of mortality and cardiovascular morbidity in people with diabetes mellitus and a systolic blood pressure more than 140 mm Hg, however, further treatment is associated with an increased risk of cardiovascular death, with no observed benefit.
Effects of Blood Pressure Lowering on Clinical Outcomes According to Baseline Blood Pressure and Cardiovascular Risk in Patients With Type 2 Diabetes Mellitus: The ADVANCE Trial
TLDR
Adults with diabetes mellitus appear to benefit from more intensive BP treatment even at levels of BP and CVD risk that some guidelines do not currently recommend for intervention.
Effects of blood pressure lowering on outcome incidence in hypertension: 7. Effects of more vs. less intensive blood pressure lowering and different achieved blood pressure levels – updated overview and meta-analyses of randomized trials
TLDR
Updating of previous meta-analyses indicates that more vs. less intense BP lowering can reduce not only stroke and coronary events, but also cardiovascular mortality.
Effect of intensive lowering of systolic blood pressure treatment on heart failure events: a meta-analysis of randomized controlled studies
TLDR
The existing data support the results of a positive association between intensive SBP-lowering treatment and HF risk, especially for those patients without diabetes and those older than 65 years, however, additional prospective studies are still needed to confirm these associations.
...
...