Effects of Intensive Antihypertensive Treatment on Chinese Hypertensive Patients Older Than 70Years

This study was performed to investigate whether intensive antihypertensive treatment with achieved blood pressure (BP) 140/90mm Hg, as compared with standard treatment with achieved BP 150/90mm Hg, could further improve cardiovascular outcomes in Chinese hypertensive patients older than 70years. A total of 724 participants were randomly assigned to intensive or standard antihypertensive treatment. After a mean follow-up of 4years, the mean achieved BP was 135.7/76.2mm Hg in the intensive treatment group and 149.7/82.1mm 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 136/76mm Hg was beneficial for Chinese hypertensive patients older than 70years. Long-term visit-to-visit variability in systolic BP was positively associated with the incidence of cardiovascular events. (C) 2013 Wiley Periodicals, Inc.