A multicenter, randomized clinical trial of patients aged 75 years or older concluded that treating to a systolic blood pressure (SBP) target of less than 120 mm Hg compared with an SBP target of less than 140 mm Hg resulted in significantly lower rates of fatal and nonfatal major cardiovascular events and death from any cause. Among 2636 participants (mean age, 79.9 years; 37.9% women, median follow-up of 3.14 years), there was a significantly lower rate of the primary composite outcome (nonfatal myocardial infarction, acute coronary syndrome not resulting in a myocardial infarction, nonfatal stroke, nonfatal acute decompensated heart failure, and death from cardiovascular causes, 102 events in the intensive treatment group vs 148 events in the standard treatment group), and all-cause mortality (73 deaths vs 107 deaths, respectively). The overall rate of serious adverse events was not different between treatment groups. Absolute rates of hypotension were 2.4% in the intensive treatment group vs 1.4% in the standard treatment group, 3.0 % vs 2.4%, respectively, for syncope, 4.0% vs 2.7% for electrolyte abnormalities, 5.5% vs 4.0% for acute kidney injury, and 4.9% vs 5.5% for injurious falls. Source: http://jama.jamanetwork.com/
一个对年龄75岁以上患者的多中心，随机临床试验得出的结论是收缩压降至120毫米汞柱以下，与收缩压降至140毫米汞柱以下相比，致死性和非致死性主要心血管事件及任何原因所致死亡显著较低。在2636名参与者（平均年龄79.9岁，37.9％为女性，中位随访3.14年）中，主要复合指标发生率（包括非致死性心梗，未致心梗的急性冠脉综合征，非致命性中风，非致命性急性失代偿性心衰，以及心源性死亡，强化治疗组102件与标准治疗组148件）和全因死亡率（分别为73人与107人死亡）显著较低。严重不良事件的总发生率两组相当。强化治疗组和标准治疗组低血压的发生率分别为2.4％和1.4％，晕厥分别为3.0％和2.4％，电解质紊乱分别为4.0％和2.7％，急性肾损伤分别为5.5％和4.0％，摔伤分别为4.9％和5.5％。来源：http://jama.jamanetwork.com/