Risk for future stroke, MI, other cardiovascular events significantly reduced with intensive treatment targeting BP <120 mm Hg
FRIDAY, Nov. 13, 2026 (HealthDay News) — For adults with previous ischemic stroke or transient ischemic attack, targeting a systolic blood pressure <120 mmHg versus <140 mmHg yields a lower incidence of major cardiovascular events, according to a study published online Nov. 7 in the New England Journal of Medicine to coincide with the American Heart Association Scientific Sessions 2026, held from Nov. 6 to 9 in Chicago.
Gisele Sampaio Silva, M.D., M.P.H., Ph.D., from the Hospital Israelita Albert Einstein in São Paulo, Brazil, and colleagues conducted a multicenter, randomized trial at 30 sites involving participants with elevated blood pressure and previous ischemic stroke or transient ischemic attack. Participants were randomly assigned to receive intensive treatment targeting a systolic blood pressure <120 mmHg or to receive standard treatment targeting a systolic blood pressure of <140 mmHg (2,172 and 2,196 individuals, respectively).
The researchers found that during the follow-up period, excluding the first three months, the mean systolic blood pressure was 122.0 ± 11.5 and 135.2 ± 9.7 mmHg in the intensive-treatment and standard-treatment groups, respectively, with a mean difference of 13.1 mmHg between the groups. A primary outcome event (composite of death from cardiovascular causes, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for unstable angina or heart failure) occurred in 10.9 and 13.5 percent of patients in the intensive treatment and standard treatment groups, respectively, during a median follow-up of 3.9 years (3.25 versus 4.11 events per 100 person-years; hazard ratio, 0.79). With intensive treatment, the composite renal outcome (sustained reduction of ≥50 percent in the estimated glomerular filtration rate or progression to end-stage renal disease) was more common. The groups had a similar overall incidence of serious adverse events.
“We emphasize that achieving lower blood pressure safely requires appropriate medical supervision and additional monitoring, particularly of kidney function,” Sampaio said in a statement.
Several authors disclosed ties to the biopharmaceutical industry.
Abstract/Full Text (subscription or payment may be required)
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