Importance of Achieving Target Blood Pressure

Risk Factors for Hypertensive Patients

Achieving target blood pressure is crucial for hypertensive individuals, who face an elevated risk of cardiovascular events. This study aimed to explore whether meeting blood pressure targets provides a protective benefit or if it is linked to a higher risk of cardiovascular-related adverse events.

Guidelines on Target Blood Pressure

Effective cardiovascular protection is vital for patients at high risk for cardiovascular incidents. Current guidelines suggest that achieving a target blood pressure of less than 140/90 mmHg may decrease the likelihood of such events. However, it appears that various cardiovascular outcomes, such as stroke and heart failure, are more significantly influenced by systolic blood pressure.

Personalized Blood Pressure Control

Therefore, the approach to cardiovascular risk reduction through blood pressure management may require personalization based on the specific benefits for each patient.

Study Overview

Research Published in The Lancet

A study published in The Lancet investigated the cardiovascular outcomes of reaching blood pressure targets among hypertensive, high-risk patients aged 55 years and older.

Data Analysis from ONTARGET and TRANSCEND Trials

The research analyzed data from previously reported outcomes of the ONTARGET and TRANSCEND trials, which evaluated the effects of ramipril, telmisartan, and their combination over a median follow-up period of 56 months.

Participant Demographics

Participants in both studies were aged 55 years or older and had no history of heart failure. They also had a documented history of coronary artery disease, peripheral artery disease, transient ischemic attack, stroke, or diabetes. The study recruited patients from 733 centers across 40 countries.

Randomized Assignments in Trials

In the ONTARGET trial, participants were randomly assigned to receive oral ramipril, telmisartan, or a combination of both. Meanwhile, the TRANSCEND trial participants were randomly assigned to receive either telmisartan or a placebo. Notably, participants in both trials were resistant to ACE inhibitors.

Data Analysis and Outcomes

The complete data set included 30,937 participants. The primary composite outcomes evaluated were cardiovascular death, myocardial infarction, stroke, and hospital admissions for heart failure. Patients were categorized based on their baseline and mean blood pressure during treatment, utilizing specific cut-offs for systolic blood pressure (SBP).