November 10, 2015

A Randomized Trial of Intensive versus Standard Blood-Pressure Control

In this RCT, a intensive BP target of less than 120 mm Hg was compared to a standard target of less than 140 mm Hg. The primary outcome (a composite of myocardial infarction, other acute coronary syndromes, stroke, heart failure, or death from cardiovascular causes) was reduced (1.65% per year vs. 2.19% per year; HR with intensive treatment, 0.75; 95% CI, 0.64 to 0.89; P<0.001). All cause mortality was also reduced in the intensive group with HR 0.73; 95% CI 0.60 to 0.90; p = 0.003. Adverse events (including hypotension, syncope, electrolyte abnormalities and acute kidney injury) were more common in the intensive arm, though falls resulting in injury were not.

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