J Hypertens. 2019 Nov;37(11):2135-2144. doi: 10.1097/HJH.0000000000002176.
: On the basis of the benefits of antihypertensive treatment, progressively intensive treatment is advocated. However, it remains controversial whether intensive blood pressure control might increase the frequency of serious adverse events (SAEs) compared with moderate control. This review assessed the occurrence of SAEs in blood pressure treatment with predefined blood pressure targets. Seven original studies and eight post hoc analyses (derived from two original studies) met the inclusion criteria. Compared with moderate blood pressure treatment, intensive treatment was associated with a significant increase in treatment-related SAEs (Sign-test: P = 0.0002, Wilcoxon signed-rank test: P = 0.001). However, comparability between studies was limited, due to unclear determinations about the treatment-relatedness of adverse events, missing definitions of SAEs and variations in recording methods. Thus, a meta-analysis was not justified. The definitions of serious adverse events and methods of recording and reporting need to be improved and standardized to facilitate the comparison of results.
基于降压治疗的益处，提倡进行递进式强化治疗。然而，与适度降压控制相比，强化血压控制是否会增加严重不良事件（SAE）的发生频率仍存在争议。本综述评估了在预设血压目标下降压治疗中 SAE 的发生情况。符合纳入标准的有 7 项原始研究和 8 项事后分析（来自两项原始研究）。与中度血压治疗相比，强化治疗与治疗相关的 SAE 显著增加（Sign 检验：P=0.0002，Wilcoxon 符号秩检验：P=0.001）。然而，由于对不良事件与治疗的相关性、SAE 的定义以及记录方法的差异存在不确定因素，研究之间的可比性有限。因此，不支持进行荟萃分析。需要改进和标准化严重不良事件的定义以及记录和报告方法，以方便比较结果。
