Effects Of Intensive Antihypertension On Major Cardiovascular Events: A Meta-analysis

Aims: To evaluate the effects of intensive antihypertension on major cardiovascular events in patients when achieved blood pressure is less than 130/80 mm Hg by means of Meta-analysis.The patients are mostly with high-normal blood pressure or mild hypertension,and without heart,brain and kidney serious diseases.Methods: EMBASE,MEDLINE,the Cochrane Library,Web of Science and the China Biology Medicine disc(CBMdisc)were searched up for randomized controlled trials to September 10,2016.We also searched Clinical Trials.gov website for randomized trials that were registered and completed but not yet published.Relevant publications were examined for references until no further studies were found.We also searched the citations in trials and previous meta-analysis and review articles.Screening literature based on inclusion and exclusion criteria,data extraction of included literature,and quality assessment of studies through the Cochrane risk assessment tool.The data were extracted by Rev Man 5.1 statistical software.Results: 10 randomized controlled trials comprising a total of 57474 patients were finally included.More intensive blood pressure(BP)lowering decreased the risk of major cardiovascular events by 16%(RR,0.84,95% confidence interval [CI],0.79–0.88,p <0.001)compared to standard BP lowering.Achieving an intensive BP target was associated with a significantly lower risk of stroke(RR,0.79;95%CI,0.71–0.89;p<0.001)and heart failure(RR,0.75;95%CI,0.66–0.85;p<0.001),and the risk of cardiovascular death(RR,0.89;95% CI,0.80-0.98;P = 0.02)and myocardial infarction(RR,0.86;95% CI,0.79-0.93;P = 0.0005)were also reduced to a certain extent.Conclusions: Achieving an intensive BP target of lower than 130/80 mm Hg significantly reduced the risk of major cardiovascular events in patients with high-normal blood pressure or mild hypertension and without heart,brain and kidney serious diseases compared to standard BP target of 130-139/80-89 mm Hg.