Beneficial Effect of Intensive BP Control Does Not Persist

MONDAY, Oct. 17, 2022 (HealthDay News) — The beneficial effect of intensive blood pressure (BP) treatment on cardiovascular and all-cause mortality does not persist, according to a study published online Oct. 12 in JAMA Cardiology.

Byron C. Jaeger, Ph.D., from the Wake Forest University School of Medicine in Winston-Salem, North Carolina, and colleagues conducted a secondary analysis of a multicenter randomized clinical trial involving patients aged 50 years or older with hypertension and increased cardiovascular risk to examine the long-term effects of randomization to intensive treatment. Participants were randomly assigned to a systolic blood pressure (SBP) goal of <120 mm Hg (intensive treatment group; 4,678 participants) versus <140 mm Hg (standard treatment group; 4,683 participants).

The researchers found that intensive treatment was beneficial for cardiovascular and all-cause mortality (hazard ratios [95 percent confidence intervals], 0.66 [0.49 to 0.89] and 0.83 [0.68 to 1.01], respectively) during a median intervention period of 3.3 years. There was no longer evidence of benefit for cardiovascular or all-cause mortality at a median follow-up of 8.8 years (hazard ratios [95 percent confidence intervals], 1.02 [0.84 to 1.24] and 1.08 [0.94 to 1.23], respectively).

“Given steadily increasing mean SBP levels in participants randomized to intensive treatment after the trial, these results suggest that maintaining more intensive BP targets throughout adulthood will likely be essential for long-term cardiovascular disease risk management,” the authors write.

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

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