Blood pressure targets for the treatment of people with hypertension and cardiovascular disease

Abstract

We found no di erences in total numbers of deaths, heart or vascular deaths, total heart problems, or vascular problems, nor in total serious harms, between lower and standard blood pressure goal approaches. Based on very little information, we found more dropouts resulting from drug-related harms in the lower blood pressure target group and no overall health benefit among people in the lower target group. Quality of the evidence The best available evidence does not support lower blood pressure goals over standard goals in people with elevated blood pressure and heart or vascular problems. More new trials are needed to examine this question. Overall, the quality of evidence was assessed as low to moderate according to the GRADE assessment. Blood pressure targets for the treatment of people with hypertension and cardiovascular disease (Review)

Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

“…A range of strategies including primary care management and reductions in sodium intake are known to be potentially effective in reducing the burden of this critical risk factor. 32 , 33 …”

Effects of wine on blood pressure, glucose parameters, and lipid profile in type 2 diabetes mellitus

“…People with hypertension and established cardiovascular diseases are at particular high risk in general population. [19,20] Therefore, the management of elevated BP is a critical component of the comprehensive clinical management of diabetes. Previous study had revealed that in well-controlled type 2 diabetic individuals moderate red wine drinking could raise awake BP and lower asleep BP.…”

Update on the Hong Kong Reference Framework for Hypertension Care for Adults in Primary Care Settings—review of evidence on the definition of high blood pressure and goal of therapy

“…21,22 Recent systemic reviews and metaanalyses have proposed that intensive BP-lowering treatment increases the risk of cardiovascular death without observable benefits; these studies have concluded that there is insufficient evidence to justify the lower BP goal. [24][25][26] A large retrospective cohort study in Hong Kong, which involved around 100 000 Chinese patients with diabetes mellitus receiving primary care services, identified that the SBP range for the lowest risk of cardiovascular diseases and allcause mortality was 130 to 134 mm Hg. In addition, a J-curve relationship between SBP and all outcomes of fatal and non-fatal cardiovascular diseases was observed, and patients with SBP <125 mm Hg were found to have significantly higher hazard ratio to all composite outcomes.…”