- Question
- Does an intensive systolic blood-pressure target reduce cardiovascular events in older patients with hypertension compared with a standard target?
- Design
- Multicenter, randomized, controlled, open-label trial with blinded endpoint assessment in Chinese patients; 8511 patients were randomized and followed for a median of 3.34 years.
- Population
- Chinese patients aged 60 to 80 years with hypertension.
- Intervention
- Intensive treatment with a systolic blood-pressure target of 110 to less than 130 mm Hg.
- Control
- Standard treatment with a systolic blood-pressure target of 130 to less than 150 mm Hg.
- Primary outcome
- Composite of stroke, acute coronary syndrome (acute myocardial infarction and hospitalization for unstable angina), acute decompensated heart failure, coronary revascularization, atrial fibrillation, or death from cardiovascular causes.
- Results
- At 1 year, mean systolic blood pressure was 127.5 mm Hg with intensive treatment and 135.3 mm Hg with standard treatment. The primary outcome occurred in 147 patients (3.5%) in the intensive group versus 196 (4.6%) in the standard group (HR 0.74; 95% CI 0.60 to 0.92; P = 0.007). The HR for stroke was 0.67 (95% CI 0.47 to 0.97).
- Safety
- Safety and renal outcomes did not differ significantly between groups, except for a higher incidence of hypotension in the intensive-treatment group.
- Conclusion
- In older patients with hypertension, an intensive systolic target of 110 to less than 130 mm Hg lowered cardiovascular events compared with the standard target.
- Why it matters
- It provided evidence supporting lower blood-pressure targets in older hypertensive patients, a population in which the appropriate target had been unclear.
Card generated automatically with AI from the abstract of the original publication and the trial registry; every figure was checked against those sources. It may contain errors: verify the data at the source before using it for clinical decisions.
Generated on October 14, 2026