{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T05:46:55Z","timestamp":1778132815501,"version":"3.51.4"},"reference-count":40,"publisher":"Sociedade Brasileira de Cardiologia","issue":"3","license":[{"start":{"date-parts":[[2025,3,1]],"date-time":"2025-03-01T00:00:00Z","timestamp":1740787200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,3,1]],"date-time":"2025-03-01T00:00:00Z","timestamp":1740787200000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,3,1]],"date-time":"2025-03-01T00:00:00Z","timestamp":1740787200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq. Bras. Cardiol."],"abstract":"<jats:p>Resumo  Fundamento  O controle rigoroso da press\u00e3o arterial tem sido investigado como uma estrat\u00e9gia para reduzir eventos cardiovasculares graves em pacientes hipertensos. No entanto, ainda existem d\u00favidas sobre o impacto de metas intensivas de tratamento anti-hipertensivo (meta &lt; 130\/80 mmHg) em compara\u00e7\u00e3o com metas convencionais (\u2265 130\/80 mmHg) na preven\u00e7\u00e3o de infarto do mioc\u00e1rdio, acidente vascular cerebral, mortalidade e poss\u00edveis eventos adversos do tratamento.  Objetivo  Avaliar a efic\u00e1cia de metas intensivas de tratamento anti-hipertensivo na redu\u00e7\u00e3o de eventos cardiovasculares cr\u00edticos em compara\u00e7\u00e3o com metas usuais.  M\u00e9todos  Esta revis\u00e3o sistem\u00e1tica incluiu ensaios cl\u00ednicos randomizados (ECRs) que compararam metas intensivas de controle da press\u00e3o arterial com metas convencionais em adultos com 18 anos ou mais. Foram inclu\u00eddos estudos com pelo menos um dos seguintes desfechos: mortalidade, infarto do mioc\u00e1rdio, acidente vascular cerebral, progress\u00e3o para doen\u00e7a renal cr\u00f4nica em est\u00e1gios IV ou V, necessidade de di\u00e1lise ou transplante renal. As bases de dados Medline, Embase e Cochrane Library foram pesquisadas at\u00e9 maio de 2024. A avalia\u00e7\u00e3o do risco de vi\u00e9s foi realizada por dois revisores independentes utilizando a ferramenta Risk of Bias 2 (RoB 2) da Colabora\u00e7\u00e3o Cochrane. A s\u00edntese dos resultados foi conduzida por meio de metan\u00e1lise para o desfecho composto de infarto do mioc\u00e1rdio, acidente vascular cerebral e mortalidade por todas as causas. A certeza da evid\u00eancia cient\u00edfica e a for\u00e7a de recomenda\u00e7\u00e3o seguiram os m\u00e9todos propostos pela ferramenta GRADE (Grading of Recommendations Assessment, Development and Evaluation).  Resultados  Foram inclu\u00eddos nove ECRs com mais de 34.000 participantes. O tratamento intensivo foi associado a uma redu\u00e7\u00e3o de 13% nos eventos cardiovasculares. Nos estudos com baixo risco de vi\u00e9s, a redu\u00e7\u00e3o foi de 17%, com alta certeza da evid\u00eancia. Separadamente, observou-se uma redu\u00e7\u00e3o significativa nos desfechos de infarto do mioc\u00e1rdio e acidente vascular cerebral, mas n\u00e3o na mortalidade por todas as causas. Dados limitados foram encontrados sobre a progress\u00e3o da doen\u00e7a renal e necessidade de di\u00e1lise ou transplante renal.  Conclus\u00e3o  As evid\u00eancias de alta qualidade sugerem que metas mais intensivas de tratamento anti-hipertensivo reduzem significativamente os eventos cardiovasculares. Contudo, a escolha das metas de tratamento deve ser individualizada, considerando fatores como idade, fragilidade, o risco cardiovascular individual e a possibilidade de eventos adversos. A ades\u00e3o ao tratamento \u00e9 fundamental para o sucesso terap\u00eautico.<\/jats:p>","DOI":"10.36660\/abc.20240761","type":"journal-article","created":{"date-parts":[[2025,4,3]],"date-time":"2025-04-03T21:22:07Z","timestamp":1743715327000},"source":"Crossref","is-referenced-by-count":3,"title":["Revis\u00e3o Sistem\u00e1tica sobre a Efic\u00e1cia de Metas Intensivas do Tratamento Anti-Hipertensivo: Recomenda\u00e7\u00e3o da Sociedade Brasileira de Cardiologia (SBC)"],"prefix":"10.36660","volume":"122","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7040-396X","authenticated-orcid":false,"given":"Andr\u00e9a Araujo","family":"Brand\u00e3o","sequence":"first","affiliation":[{"name":"Universidade do Estado do Rio de Janeiro,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9490-7997","authenticated-orcid":false,"given":"Cibele Isaac Saad","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"Pontif\u00edcia Universidade Cat\u00f3lica de S\u00e3o Paulo,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4865-6442","authenticated-orcid":false,"given":"Luiz Aparecido","family":"Bortolotto","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9901-6421","authenticated-orcid":false,"given":"Leonardo Castro","family":"Luna","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Cardiologia,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9487-6139","authenticated-orcid":false,"given":"Bruno Monteiro","family":"Barros","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Cardiologia,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0797-572X","authenticated-orcid":false,"given":"Mario Fritsch Toros","family":"Neves","sequence":"additional","affiliation":[{"name":"Universidade do Estado do Rio de Janeiro,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7368-4704","authenticated-orcid":false,"given":"Ana Fl\u00e1via de Souza","family":"Moura","sequence":"additional","affiliation":[{"name":"Escola Bahiana de Medicina e Sa\u00fade P\u00fablica,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3655-4761","authenticated-orcid":false,"given":"Frida Liane","family":"Plavnik","sequence":"additional","affiliation":[{"name":"Hospital Alem\u00e3o Oswaldo Cruz,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2081-6846","authenticated-orcid":false,"given":"Luciano Ferreira","family":"Drager","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Osni","family":"Moreira Filho","sequence":"additional","affiliation":[{"name":"Cl\u00ednica Gapski Moreira,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1265-1930","authenticated-orcid":false,"given":"Weimar Kunz Sebba Barroso de","family":"Souza","sequence":"additional","affiliation":[{"name":"Universidade Federal de Goi\u00e1s,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wilson","family":"Nadruz","sequence":"additional","affiliation":[{"name":"UNICAMP,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"22636","published-online":{"date-parts":[[2025,3]]},"reference":[{"key":"ref1","series-title":"Global Health Observatory Data Repository","year":"2023"},{"issue":"6","key":"ref2","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1161\/CIRCULATIONAHA.115.018912","article-title":"Global Disparities of Hypertension Prevalence and Control: A Systematic Analysis of Population-Based Studies from 90 Countries","volume":"134","author":"Mills KT","year":"2016","journal-title":"Circulation"},{"key":"ref3","series-title":"Vigitel Brasil 2020: Vigil\u00e2ncia de Fatores de Risco e Prote\u00e7\u00e3o para Doen\u00e7as Cr\u00f4nicas por Inqu\u00e9rito Telef\u00f4nico","year":"2021"},{"issue":"10149","key":"ref4","first-page":"760","article-title":"The Burden of Disease in Brazil, 1990-2019: A Systematic Analysis for the Global Burden of Disease Study 2019","volume":"392","year":"2018","journal-title":"Lancet"},{"issue":"3","key":"ref5","first-page":"7","article-title":"7th Brazilian Guideline of Arterial Hypertension: Chapter 2 - 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Blood Press"},{"issue":"3","key":"ref17","doi-asserted-by":"crossref","first-page":"1086","DOI":"10.1046\/j.1523-1755.2002.00213.x","article-title":"Effects of Aggressive Blood Pressure Control in Normotensive Type 2 Diabetic Patients on Albuminuria, Retinopathy and Strokes","volume":"61","author":"Schrier RW","year":"2002","journal-title":"Kidney Int"},{"issue":"12","key":"ref18","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.1016\/j.amjhyper.2006.05.011","article-title":"Effect of Intensive Blood Pressure Control with Valsartan on Urinary Albumin Excretion in Normotensive Patients with Type 2 Diabetes","volume":"19","author":"Estacio RO","year":"2006","journal-title":"Am J Hypertens"},{"issue":"9689","key":"ref19","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1016\/S0140-6736(09)61340-4","article-title":"Usual versus Tight Control of Systolic Blood Pressure in Non-Diabetic Patients with Hypertension (Cardio-Sis): An Open-Label Randomised Trial","volume":"374","author":"Verdecchia P","year":"2009","journal-title":"Lancet"},{"issue":"10","key":"ref20","doi-asserted-by":"crossref","first-page":"918","DOI":"10.1056\/NEJMoa0910975","article-title":"Intensive Blood-Pressure Control in Hypertensive Chronic Kidney Disease","volume":"363","author":"Appel LJ","year":"2010","journal-title":"N Engl J Med"},{"issue":"17","key":"ref21","doi-asserted-by":"crossref","first-page":"1575","DOI":"10.1056\/NEJMoa1001286","article-title":"Effects of Intensive Blood-Pressure Control in Type 2 Diabetes Mellitus","volume":"362","author":"Cushman WC","year":"2010","journal-title":"N Engl J Med"},{"issue":"9891","key":"ref22","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1016\/S0140-6736(13)60852-1","article-title":"Blood-Pressure Targets in Patients with Recent Lacunar Stroke: The SPS3 Randomised Trial","volume":"382","author":"Benavente 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Med"},{"issue":"4","key":"ref26","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1177\/01410768231156997","article-title":"Intensive versus Standard Blood Pressure Control in Older Persons with or Without Diabetes: A Systematic Review and Meta-Analysis of Randomised Controlled Trials","volume":"116","author":"Seidu S","year":"2023","journal-title":"J R Soc Med"},{"issue":"10285","key":"ref27","doi-asserted-by":"crossref","first-page":"1625","DOI":"10.1016\/S0140-6736(21)00590-0","article-title":"Pharmacological Blood Pressure Lowering for Primary and Secondary Prevention of Cardiovascular Disease Across Different Levels of Blood Pressure: An Individual Participant-Level Data Meta-Analysis","volume":"397","year":"2021","journal-title":"Lancet"},{"key":"ref28","doi-asserted-by":"crossref","first-page":"j4008","DOI":"10.1136\/bmj.j4008","article-title":"AMSTAR 2: A Critical Appraisal Tool for Systematic Reviews that Include Randomised or Non-Randomised Studies of Healthcare Interventions, or Both","volume":"358","author":"Shea BJ","year":"2017","journal-title":"BMJ"},{"issue":"7695","key":"ref29","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1016\/S0140-6736(71)92205-7","article-title":"Long-Term Observations on High Blood-Pressure Presenting in Fit Young Men","volume":"1","author":"Stewart IM","year":"1971","journal-title":"Lancet"},{"issue":"6799","key":"ref30","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1136\/bmj.303.6799.385","article-title":"Relation of Low Diastolic Blood Pressure to Coronary Heart Disease Death in Presence of Myocardial Infarction: The Framingham Study","volume":"303","author":"D'Agostino RB","year":"1991","journal-title":"BMJ"},{"issue":"5","key":"ref31","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1161\/HYPERTENSIONAHA.117.10479","article-title":"Blood Pressure Measurement in SPRINT (Systolic Blood Pressure Intervention Trial)","volume":"71","author":"Johnson KC","year":"2018","journal-title":"Hypertension"},{"issue":"2","key":"ref32","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.116.004536","article-title":"Implications of Blood Pressure Measurement Technique for Implementation of Systolic Blood Pressure Intervention Trial (SPRINT)","volume":"6","author":"Agarwal R","year":"2017","journal-title":"J Am Heart Assoc"},{"issue":"11","key":"ref33","doi-asserted-by":"crossref","first-page":"2329","DOI":"10.1161\/HYPERTENSIONAHA.124.23597","article-title":"Optimal Antihypertensive Systolic Blood Pressure: A Systematic Review and Meta-Analysis","volume":"81","author":"Whelton PK","year":"2024","journal-title":"Hypertension"},{"issue":"10449","key":"ref34","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/S0140-6736(24)01028-6","article-title":"Lowering Systolic Blood Pressure to Less Than 120 mm Hg versus Less than 140 mm Hg in Patients with High Cardiovascular Risk with and Without Diabetes or Previous Stroke: An Open-Label, Blinded-Outcome, Randomised Trial","volume":"404","author":"Liu J","year":"2024","journal-title":"Lancet"},{"key":"ref35","series-title":"Programa Farm\u00e1cia Popular do Brasil: Acesso aos Medicamentos","year":"2024"},{"issue":"8","key":"ref36","doi-asserted-by":"crossref","first-page":"1296","DOI":"10.1016\/S0149-2918(01)80109-0","article-title":"A Systematic Review of the Associations between Dose Regimens and Medication Compliance","volume":"23","author":"Claxton AJ","year":"2001","journal-title":"Clin Ther"},{"issue":"2","key":"ref37","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1161\/HYPERTENSIONAHA.109.139816","article-title":"Compliance, Safety, and Effectiveness of Fixed-Dose Combinations of Antihypertensive Agents: A Meta-Analysis","volume":"55","author":"Gupta AK","year":"2010","journal-title":"Hypertension"},{"issue":"2","key":"ref38","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1016\/j.pec.2015.08.026","article-title":"Self-Monitoring Blood 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