The secondary analysis of a multicenter randomized clinical trial in the US and Puerto Rico showed that the beneficial effect of intensive treatment on cardiovascular and all-cause mortality did not persist after the trial, with increasing outpatient systolic blood pressure (SBP) levels in participants randomized to intensive treatment following the trial. The trial randomized 9361 participants (mean age 67.9 years, 35.6% women) from 2010, with trial intervention ending in 2015, and trial close-out visits through 2016. Over a median (IQR) intervention period of 3.3 years, intensive treatment was beneficial for both cardiovascular mortality (hazard ratio [HR], 0.66) and all-cause mortality (HR, 0.83). However, at the extended median (IQR) follow-up of 8.8 years, there was no longer evidence of benefit for cardiovascular mortality (HR, 1.02) or all-cause mortality (HR, 1.08). In a subgroup of 2944 participants, the estimated mean outpatient SBP among participants randomized to intensive treatment increased from 132.8 mm Hg at 5 years to 140.4 mm Hg at 10 years following randomization. The findings suggest the importance of sustaining SBP control to reduce mortality. Source: https://jamanetwork.com/
