Systolic Target Under 130 mmHg Cuts Cardiovascular Events in Patients Over 60, Meta-Analysis Shows
A Bayesian network meta-analysis indicates that lowering systolic blood pressure below 130 mmHg reduces major adverse cardiovascular events in older patients.
Researchers from the Second Affiliated Hospital of Chongqing Medical University evaluated optimal systolic blood pressure targets for patients aged 60 and older. In a study published in Cardiovascular Innovations and Applications, the team conducted a Bayesian network meta-analysis of six randomized clinical trials identified through January 2022 to assess clinical outcomes under varying levels of blood pressure control doi.org
Cardiovascular Innovations and Applicationsdoi.orgOpen source ↗.
Therapeutic regimens across the included trials were classified into three groups according to the final achieved systolic blood pressure: under 130 mmHg, 130 to 139 mmHg, and 140 mmHg or higher. The evaluated clinical endpoints included major adverse cardiovascular events, cardiovascular mortality, all-cause mortality, myocardial infarction, heart failure, and stroke.
Cardiovascular Risk Reduction
The meta-analysis demonstrated that achieving a systolic blood pressure below 130 mmHg significantly reduced the incidence of major adverse cardiovascular events compared with an achieved pressure of 140 mmHg or higher (odds ratio 0.43, 95% CI 0.19–0.76). Comparisons between other blood pressure ranges did not reveal statistically significant differences for this composite endpoint.
Although the data showed a general trend toward more intensive blood pressure reduction yielding better outcomes for individual endpoints, the differences between cohorts remained statistically non-significant. Specific evaluations of all-cause mortality, cardiovascular mortality, stroke, heart failure, and myocardial infarction showed no definitive variations between the control targets doi.org
Cardiovascular Innovations and Applicationsdoi.orgOpen source ↗.
Clinical Target Considerations
The authors noted that an achieved systolic pressure below 130 mmHg might represent an optimal target for older individuals undergoing hypertension management. However, the study group emphasized that further clinical trials are required to corroborate these findings across diverse populations.
