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Evidence for lowering blood pressure targets ‘inconsistent’, review finds

The evidence for lowering blood pressure targets may be inconclusive, according to the findings of a recent meta-analysis.

The analysis, carried out by US researchers, found that the evidence for reducing blood pressure targets to below 140mmHg in over-60s lacked consistency.

This comes as NICE announced plans in 2016 to consider lowering blood pressure targets below the currently recommended threshold of 140mmHg in a hypertension guideline update.

But the study, published in Annals of Internal Medicine, found inconsistencies between the results of trials looking at outcomes when blood pressure was lowered to 120mmHg – with the SPRINT trial reporting marked reductions in mortality and cardiac events that were not replicated in a similar large-scale trial.

The researchers found that although lowering blood pressure targets in higher risk patients may be of value, the evidence for its benefit in those with lower baseline blood pressures was limited.

‘Lower treatment targets (<140/85mmHg) are likely to be beneficial for some patients at high cardiovascular risk, but the results across trials are less consistent. Lower treatment targets are associated with higher medication burden and an increased risk for short-term harms, such as hypotension’, the wrote in the report.

As a result of the research, hypertension guidelines published this week in the US recommend that over-60s should try to achieve a systolic blood pressure of 150mmHg or less.

‘The evidence showed that any additional benefit from aggressive blood pressure control is small, with a lower magnitude of benefit and inconsistent results across outcomes,’ said Dr Nitin Damle, president of the American College of Physicians, which published the guidelines with the American Academy of Family Physicians.


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