Hypertension Targeting 120 mmHg: survival benefit after 3 years, but high renal risk.

Q4 Medicine Prescrire International Pub Date : 2017-01-01
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Abstract

In a randomised trial, reducing the systolic blood pressure target to around 120 mmHg led to a reduction in all-cause mortality compared to a tar- get of around 135 mmHg: after about 3 years, 3.3% of patients in the "inten- sive" treatment group had died versus 4.5% in the "standard" treatment group. The trial was not blinded, however.The patients included were aged 50 years or older, at high risk of cardiovascular events, often overweight but not dia- betic, and had no history of stroke or symptomatic heart failure. This survival benefit was accompan- ied by a twofold increase in serious adverse effects, in particular renal effects, and cannot be extrapolated to the majority of hypertensive patients.

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高血压目标为120mmhg: 3年后生存获益,但肾脏风险高。
在一项随机试验中,将收缩压目标降低到120毫米汞柱左右,与135毫米汞柱左右的目标相比,全因死亡率降低:大约3年后,3.3%的“强化”治疗组患者死亡,而4.5%的“标准”治疗组患者死亡。然而,该试验并不是盲法的。纳入的患者年龄在50岁或以上,有心血管事件的高风险,通常超重但没有糖尿病,没有中风或症状性心力衰竭的病史。这种生存获益伴随着严重不良反应的两倍增加,特别是肾脏影响,不能推断为大多数高血压患者。
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Prescrire International
Prescrire International Medicine-Pharmacology (medical)
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