A Chinese multicenter, randomized, controlled trial concluded that intensive treatment with a systolic blood-pressure (SBP) target of 110 to less than 130 mm Hg resulted in a lower incidence of cardiovascular events than standard treatment with a target of 130 to less than 150 mm Hg. Of the 8511 hypertensive patients 60 to 80 years of age enrolled in the trial, 4243 were randomly assigned to the intensive-treatment group with a SBP target of 110 to less than 130 mm Hg, and 4268 to the standard-treatment group with a target of 130 to less than 150 mm Hg. At 1 year of follow-up, the mean SBP was 127.5 mm Hg in the intensive-treatment group and 135.3 mm Hg in the standard-treatment group. During a median follow-up period of 3.34 years, primary-outcome events occurred in 3.5% of patients in the intensive-treatment group, as compared with 4.6% in the standard-treatment group (hazard ratio, 0.74). Most of the individual components of the primary outcome also favored intensive treatment: the hazard ratio for stroke was 0.67, acute coronary syndrome 0.67, acute decompensated heart failure 0.27, coronary revascularization 0.69, atrial fibrillation 0.96, and death from cardiovascular causes 0.72. The incidence of hypotension was higher in the intensive-treatment group, but other safety and renal outcomes did not differ significantly between the two groups. The findings are in line with a previous landmark trial in the US and support a lower SBP target. Source: https://www.nejm.org/
