Open AccessEffects of Intensive Antihypertensive Treatment on Chinese Hypertensive Patients Older Than 70 Years
Author(s) -
Wei Yong,
Jin Zhimin,
Shen Guoying,
Zhao Xiaowei,
Yang Wanhua,
Zhong Ye,
Wang Jiguang
Publication year - 2013
Publication title -
the journal of clinical hypertension
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 67
eISSN - 1751-7176
pISSN - 1524-6175
DOI - 10.1111/jch.12094
Subject(s) - medicine , blood pressure , confidence interval , proportional hazards model , cardiology , diastole , stroke (engine) , heart failure , intensive care , incidence (geometry) , intensive care medicine , mechanical engineering , physics , optics , engineering
This study was performed to investigate whether intensive antihypertensive treatment with achieved blood pressure ( BP ) ≤140/90 mm Hg, as compared with standard treatment with achieved BP ≤150/90 mm Hg, could further improve cardiovascular outcomes in Chinese hypertensive patients older than 70 years. A total of 724 participants were randomly assigned to intensive or standard antihypertensive treatment. After a mean follow‐up of 4 years, the mean achieved BP was 135.7/76.2 mm Hg in the intensive treatment group and 149.7/82.1 mm Hg in the standard treatment group. The visit‐to‐visit variability in systolic BP and diastolic BP was lower in the intensive group than that in the standard group. Intensive antihypertensive treatment, compared with the standard treatment, decreased total and cardiovascular mortality by 41.7% and 50.3%, respectively, and reduced fatal/nonfatal stroke by 42.0% and heart failure death by 62.7%. Cox regression analysis indicated that the mean systolic BP ( P =.020; 95% confidence interval, 1.006–1.069) and the standard deviation of systolic BP ( P =.033; 95% confidence interval, 1.006–1.151) were risk factors for cardiovascular endpoint events. Intensive antihypertensive treatment with achieved 136/76 mm Hg was beneficial for Chinese hypertensive patients older than 70 years. Long‐term visit‐to‐visit variability in systolic BP was positively associated with the incidence of cardiovascular events.