Faculty of Medicine, University of Oslo, Oslo, Norway.
Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Cardiology, Oslo University Hospital, Ullevaal, Oslo, Norway.
Prog Cardiovasc Dis. 2016 Nov-Dec;59(3):209-218. doi: 10.1016/j.pcad.2016.09.002. Epub 2016 Sep 13.
Although high blood pressure (BP) is the leading risk factors for cardiovascular (CV) disease, the optimal BP treatment target in order to reduce CV risk is unclear in the aftermath of the SPRINT study. The aim of this review is to assess large, randomized, and controlled trials on BP targets, as well as review selected observational analyses from other large randomized BP trials in order to evaluate the benefit of intense vs. standard BP control. None of the studies, except SPRINT, favored intense BP treatment. Some of the studies suggested favorable effects of lowering treatment target in patients with diabetes or high risk of stroke. In SPRINT, a new BP measurement method was introduced, and the results must be interpreted in light of this. The results of the observational analyses indicated the best preventive effect when achieving early and sustained BP control rather than low targets. In conclusion, today's guidelines' recommended treatment target of <140/90mmHg seems sufficient for most patients. Early and sustained BP control should be the main focus.
尽管高血压（BP）是心血管疾病（CV）的主要危险因素，但在 SPRINT 研究之后，降低 CV 风险的最佳 BP 治疗目标仍不清楚。本综述的目的是评估 BP 目标的大型随机对照试验，并回顾其他大型随机 BP 试验的选定观察性分析，以评估强化与标准 BP 控制的益处。除 SPRINT 外，没有一项研究支持强化 BP 治疗。一些研究表明，降低糖尿病或中风高危患者的治疗目标有有利影响。在 SPRINT 中，引入了一种新的 BP 测量方法，必须根据这一点解释结果。观察性分析的结果表明，早期和持续的 BP 控制而不是低目标会产生最佳的预防效果。总之，目前指南推荐的<140/90mmHg 的治疗目标对大多数患者似乎足够了。早期和持续的 BP 控制应是主要关注点。
