{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T21:19:35Z","timestamp":1791839975753,"version":"4.3.4"},"reference-count":34,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,3,5]],"date-time":"2025-03-05T00:00:00Z","timestamp":1741132800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Intern Med"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The optimal systolic blood pressure (SBP) target in patients with increased cardiovascular risk remains uncertain. This study evaluated the efficacy and safety of intensive SBP control (&lt;120\u00a0mm\u00a0Hg) compared to standard SBP control (&lt;140\u00a0mm\u00a0Hg) in patients with increased cardiovascular risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a systematic search of PubMed, Embase, Web of Science, and Cochrane Library for RCTs published from database inception through November 2024 that compared intensive SBP control (&lt;120\u00a0mm\u00a0Hg) with standard SBP control (&lt;140\u00a0mm\u00a0Hg) in adults with high cardiovascular risk. Efficacy outcomes included all\u2010cause mortality, major adverse cardiovascular events (MACE), cardiovascular death, stroke, myocardial infarction (MI), and heart failure. Safety outcomes included hypotension, syncope, arrhythmia, acute kidney injury, and electrolyte abnormalities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Five RCTs comprising 39,434 patients were included. The all\u2010cause mortality was significantly lower in the intensive SBP control group (672 of 19,712 [3.4%]) compared to the standard SBP control group (778 of 19,722 [3.9%]) (risk ratio 0.87 [95% confidence interval, 0.76\u20130.99,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.03]). The incidence of MACE, cardiovascular death, MI, stroke, and heart failure was significantly lower in the intensive SBP control group as compared to standard SBP control group. The treatment effect (MACE) was consistent across all subgroups. Conversely, intensive SBP control was associated with an increased risk of hypotension, syncope, arrhythmia, acute kidney injury, and electrolyte abnormalities.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Targeting intensive SBP control to less than 120\u00a0mm\u00a0Hg was associated with a lower incidence of all\u2010cause mortality and MACE but a higher incidence of adverse events.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/joim.20078","type":"journal-article","created":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T00:19:10Z","timestamp":1741738750000},"page":"479-491","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Systolic blood pressure targets below 120\u00a0mm\u00a0Hg are associated with reduced mortality: A meta\u2010analysis"],"prefix":"10.1111","volume":"297","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1224-9036","authenticated-orcid":false,"given":"Felix","family":"Bergmann","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacology Medical University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marlene","family":"Prager","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology Medical University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lena","family":"Pracher","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology Medical University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Sawodny","sequence":"additional","affiliation":[{"name":"Department of Pathology Medical University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gloria M.","family":"Steiner\u2010Gager","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology Medical University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernhard","family":"Richter","sequence":"additional","affiliation":[{"name":"Department of Medicine II Division of Cardiology Medical University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernd","family":"Jilma","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology Medical University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Zeitlinger","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology Medical University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg","family":"Gelbenegger","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology Medical University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anselm","family":"Jorda","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology Medical University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,3,5]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41581-019-0244-2"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.120.16483"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)00590-0"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2024.05.033"},{"issue":"6","key":"e_1_2_11_6_1","first-page":"e13","article-title":"2017 ACC\/AHA\/AAPA\/ABC\/ACPM\/AGS\/APhA\/ASH\/ASPC\/NMA\/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines","volume":"71","author":"Whelton 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