Lowering blood pressure intervention favourable for CV outcomes

A large meta-analysis showed that blood pressure intervention is beneficial for improving cardiovascular (CV) outcomes. Baseline diastolic blood pressure was not found to impact the beneficial effects [1].

Dr Amara Sarwal (University of Utah Health, UT, USA) discussed the outcomes of a large meta-analysis of 4 trials examining the effects of blood pressure goals on CV outcomes. Over 15,000 patients were included with 1,614 CV events over 59,925 person-years of follow-up. “We observed that intensive blood pressure control [ed. treatment to a systolic blood-pressure target of 110-130 mm Hg] resulted in an overall lower hazard of CV events (HR 0.79; 95% CI 0.72–0.87). A lower baseline diastolic blood pressure was associated with an increased risk of CV events in 2 of the 4 studies,” Dr Sarwal added. “The interaction term of baseline diastolic blood pressure and the blood pressure intervention on CV events was non-significant in each of the studies and pooled overall. If lowering the systolic blood pressure in those with lower baseline diastolic blood pressure is harmful, the interaction term would be significant. The non-significance of the interaction terms means that there is no evidence that lowering systolic blood pressure in those with lower baseline diastolic blood pressure is harmful [1].”

1. Sarwal A, et al. Influence of Baseline Diastolic BP (DBP) on the Effects of BP Lowering on Cardiovascular (CV) Outcomes: A Meta-Analysis of NIH BP Trials. TH-OR23, ASN Kidney Week 2022, 3–6 Nov.

 

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Posted on 8 December 2022