| Trial | control | p<0.05 | harm | NS |
|---|
| MDRD, 1994 | more intensive blood pressure lowering strategie vs less intensive blood pressure lowering strategie | End-stage renal disease 0.77 [0.65; 0.91] | | |
| HOT, 1994 | more intensive blood pressure lowering strategie vs less intensive blood pressure lowering strategie | | | Total Mortality 1.07 [0.90; 1.27] Cardiovascular mortality 1.07 [0.83; 1.38] Congestive heart failure 0.76 [0.44; 1.32] stroke 1.06 [0.83; 1.36] Major CV events 0.95 [0.82; 1.11] non cardiovascular mortality 1.06 [0.84; 1.35] |
| ABCD target (H) , 2000 | more intensive blood pressure lowering strategie vs less intensive blood pressure lowering strategie | Total Mortality 0.45 [0.22; 0.92] | | Cardiovascular mortality 0.54 [0.20; 1.43] Congestive heart failure 0.98 [0.40; 2.43] stroke 0.98 [0.40; 2.43] MI 1.12 [0.56; 2.25] Major CV events 0.91 [0.60; 1.37] non cardiovascular mortality 0.36 [0.12; 1.11] |
| AASK, 2002 | more intensive blood pressure lowering strategie vs less intensive blood pressure lowering strategie | | | Total Mortality 0.88 [0.58; 1.35] Cardiovascular mortality 0.96 [0.48; 1.93] Major CV events 0.87 [0.61; 1.24] End-stage renal disease 0.92 [0.70; 1.22] non cardiovascular mortality 0.87 [0.51; 1.50] |
| REIN-2, 2005 | more intensive blood pressure lowering strategie vs less intensive blood pressure lowering strategie | | | Total Mortality 0.67 [0.11; 3.94] Cardiovascular mortality 0.50 [0.05; 5.46] Total serious adverse events 1.39 [0.90; 2.15] End-stage renal disease 1.12 [0.74; 1.69] non cardiovascular mortality 1.00 [0.06; 15.86] |
| ABCD target (N) , 2002 | more intensive blood pressure lowering strategie vs less intensive blood pressure lowering strategie | stroke 0.32 [0.10; 0.95] | | Total Mortality 0.92 [0.50; 1.70] Cardiovascular mortality 1.48 [0.65; 3.40] Congestive heart failure 1.12 [0.50; 2.49] MI 1.30 [0.68; 2.50] Major CV events 0.97 [0.64; 1.47] non cardiovascular mortality 0.47 [0.16; 1.32] |
| Toto, 1995 | more intensive blood pressure lowering strategie vs less intensive blood pressure lowering strategie | | | Total Mortality ∞ [NaN; ∞] End-stage renal disease 2.92 [0.65; 13.15] |
| ACCORD blood pressure, 2008 | more intensive blood pressure lowering strategie vs less intensive blood pressure lowering strategie | stroke 0.58 [0.39; 0.88] | Total serious adverse events 2.58 [1.70; 3.91] | Total Mortality 1.05 [0.84; 1.30] Cardiovascular mortality 1.04 [0.73; 1.48] Congestive heart failure 0.93 [0.69; 1.24] MI 0.87 [0.69; 1.09] Major CV events 0.88 [0.74; 1.05] End-stage renal disease 1.02 [0.71; 1.46] |
| Cardio-Sis, 2009 | more intensive blood pressure lowering strategie vs less intensive blood pressure lowering strategie | Major CV events 0.53 [0.30; 0.94] left ventricular hypertrophy 0.67 [0.49; 0.92] | | Total Mortality 0.79 [0.21; 2.94] Congestive heart failure 0.42 [0.11; 1.62] stroke 0.44 [0.14; 1.40] MI 0.66 [0.19; 2.31] |
| SPRINT, 2015 | more intensive blood pressure lowering strategie vs less intensive blood pressure lowering strategie | Total Mortality 0.73 [0.60; 0.89] Cardiovascular mortality 0.57 [0.38; 0.85] Congestive heart failure 0.62 [0.45; 0.85] Major CV events 0.75 [0.64; 0.88] | | stroke 0.89 [0.63; 1.25] MI 0.83 [0.64; 1.08] End-stage renal disease 0.89 [0.42; 1.88] |
| UKPDS-HDS, 1998 | more intensive blood pressure lowering strategie vs less intensive blood pressure lowering strategie | Cardiovascular mortality 0.71 [0.52; 0.97] Congestive heart failure 0.45 [0.25; 0.80] stroke 0.58 [0.37; 0.90] Major CV events 0.69 [0.55; 0.86] | | Total Mortality 0.83 [0.65; 1.06] MI 0.80 [0.60; 1.06] |
| JATOS, 2008 | more intensive blood pressure lowering strategie vs less intensive blood pressure lowering strategie | | | Total Mortality 1.12 [0.43; 2.91] Cardiovascular mortality 1.28 [0.48; 3.43] Congestive heart failure 1.14 [0.41; 3.15] stroke 1.04 [0.69; 1.58] MI 1.00 [0.32; 3.11] Major CV events 1.05 [0.73; 1.52] |
| VANLISH, 2010 | more intensive blood pressure lowering strategie vs less intensive blood pressure lowering strategie | | | Total Mortality 0.80 [0.47; 1.37] Cardiovascular mortality 1.00 [0.44; 2.29] stroke 0.70 [0.37; 1.32] MI 1.25 [0.34; 4.63] Major CV events 0.87 [0.54; 1.40] |
| HOMED-BP, 2012 | more intensive blood pressure lowering strategie vs less intensive blood pressure lowering strategie | | | Total Mortality 0.87 [0.52; 1.45] Cardiovascular mortality 0.66 [0.16; 2.79] stroke 1.25 [0.65; 2.40] MI 0.71 [0.23; 2.22] |
| SPS3, 2013 | more intensive blood pressure lowering strategie vs less intensive blood pressure lowering strategie | | | Total Mortality 1.06 [0.82; 1.38] Cardiovascular mortality 0.89 [0.57; 1.38] Major CV events 0.86 [0.71; 1.05] |
| Wei, 2013 | more intensive blood pressure lowering strategie vs less intensive blood pressure lowering strategie | Total Mortality 0.58 [0.43; 0.79] Cardiovascular mortality 0.50 [0.31; 0.80] Congestive heart failure 0.38 [0.15; 0.96] stroke 0.58 [0.35; 0.97] Major CV events 0.59 [0.41; 0.85] | | MI 0.99 [0.40; 2.47] |
| PAST-BP, 2015 | more intensive blood pressure lowering strategie vs less intensive blood pressure lowering strategie | | | Total Mortality 2.16 [0.20; 23.50] Major CV events 0.22 [0.03; 1.72] |
| Trial | Treatments | Patients | Method |
|---|
| MDRD, 1994 | low target blood pressure (mean arterial pressure < 92 mm Hg) (n=840) vs. usual target blood pressure (mean arterial pressure < 107 mm Hg) (n=0) | patients with predominantly nondiabetic kidney disease and a glomerular filtration rate of 13 to 55 mL/min per 1.73 m2 | open Sample size: 840/0 Primary endpoint: FU duration: 2.2 y |
| HOT, 1994 | less or equal than 85 mmHg, or less or equal than 80 mmHg (n=12526) vs. less or equal than 90 mmHg (n=6264) factorial design: acetylsalicylic acid 75 mg daily vs placebo | patients with diastolic blood pressure between 100 mmHg and 115 mmHg | open Factorial plan Sample size: 12526/6264 Primary endpoint: FU duration: 3.8 y |
| ABCD target (H) , 2000 | intensive treatment with a diastolic blood pressure
goal of 75 mmHg (n=237) vs. moderate treatment with a diastolic blood pressure goal of 80-89 mmHg (n=233) factorial design: nisoldipine or enalapril as the initial antihypertensive | diabetes patients with DBP >=90 mmHg | open Parallel groups Sample size: 237/233 Primary endpoint: FU duration: 5 year |
| AASK, 2002 | arterial pressure goal of 92 mm Hg or lower (n=540) vs. usual mean arterial pressure goal of 102 to 107 mm Hg/pj (n=554) 3 x 2 factorial trial: 2 mean arterial pressure goals and initial treatment with a beta-blocker, an ACE inhibitor or a dihydropyridine calcium channel blocker | African-Americans,with diastolic blood pressure higher than 94mmHg and a glomerular filtration rate between 20 and 65 ml/min per 1.73 m2 | open Parallel groups Sample size: 540/554 Primary endpoint: FU duration: (range 3-6.4y) |
| REIN-2, 2005 | intensified (systolic/diastolic <130/80 mm Hg) blood-pressure control (n=169) vs. conventional (diastolic <90 mm Hg) blood-pressure control (n=169) | patients with non-diabetic proteinuric nephropathies receiving background treatment with the ACE inhibitor ramipril | open Sample size: 169/169 Primary endpoint: end-stage renal disease FU duration: 36 months |
| ABCD target (N) , 2002 | intensive treatment (diastolic blood pressure decrease
of 10 mmHg below baseline DBP) (n=237) vs. moderate treatment (diastolic blood pressure goal of 80-89 mmHg) (n=243) patients randomized to intensive therapy received either nisoldipine or enalapril in a blinded
manner as the initial antihypertensive medication | diabetes patients with diastolic
blood pressure between 80 and 89mmHg | open Parallel groups Sample size: 237/243 Primary endpoint: FU duration: |
| Toto, 1995 | strict blood pressure control (DBP 65 to 80 mm Hg) (n=42) vs. usual blood pressure control (DBP 85 to 95 mm Hg) (n=35) | non-diabetic patients (age 25 to 73) with long-standing hypertension (DBP > or = 95 mm Hg), chronic renal insufficiency (GFR < or = 70 m/min/1.73 m2) and a normal urine sediment | open Sample size: 42/35 Primary endpoint: GFR slope FU duration: |
| ACCORD blood pressure, 2008 | intensive therapy, targeting a systolic pressure of less than 120 mm Hg (n=2362) vs. standard therapy, targeting a systolic pressure of less than 140 mm Hg (n=2371) | patients with a median glycated hemoglobin level of 8.1% at high risk for cardiovascular events | open Factorial plan Sample size: 2362/2371 Primary endpoint: cardiovascular events FU duration: 4.7y |
| Cardio-Sis, 2009 | tighter control of systolic BP with a goal of <130 mm Hg (n=558) vs. usual control, with a goal of <140 mm Hg (n=553) | nondiabetic patients with hypertension and with SBP of 150 mm Hg or higher confirmed at two different times | open Parallel groups Sample size: 558/553 Primary endpoint: ECG evidence of LVH FU duration: 2 years |
| SPRINT, 2015 | target of 120 mm Hg (n=4678) vs. target of 140 mm Hg (n=4683) | high-risk hypertensive adults 50 years of age and older with one additional cardiovascular risk factor or preexisting kidney disease | open Parallel groups Sample size: 4678/4683 Primary endpoint: MI, ACS, stroke, HF, CV death FU duration: |
| UKPDS-HDS, 1998 | blood pressure of <150/85 mm Hg (with the use of an angiotensin converting enzyme inhibitor captopril or a beta blocker atenolol as main treatment) (n=758) vs. less tight control aiming at a blood pressure of <180/105 mm Hg (n=390) | patients with type 2 diabetes | open-label Parallel groups Sample size: 758/390 Primary endpoint: FU duration: 8.4 years |
| JATOS, 2008 | strict treatment to maintain systolic blood pressure below 140 mmHg (n=2212) vs. mild treatment to maintain systolic blood pressure below 160 but at or above 140 mmHg (n=2206) | elderly hypertensive patients with essential hypertension (65-85 years old, with a pretreatment systolic blood pressure of above 160 mmHg) | open-label Parallel groups Sample size: 2212/2206 Primary endpoint: CV and renal events FU duration: |
| VANLISH, 2010 | strict blood pressure control (<140 mm Hg) (n=-9) vs. moderate blood pressure control (> or =140 mm Hg to <150 mm Hg) (n=-9) | patients aged 70 to 84 years with isolated systolic hypertension (sitting blood pressure 160 to 199 mm Hg) | open-label Parallel groups Sample size: -9/-9 Primary endpoint: FU duration: 3.07 years (median) |
| HOMED-BP, 2012 | tight control (<125/<80 mm Hg (TC)) of HBP (n=-9) vs. usual control (125-134/80-84 mm Hg (UC)) (n=-9) | with an untreated systolic/diastolic HBP of 135-179/85-119 mm Hg | Parallel groups Sample size: -9/-9 Primary endpoint: CV events FU duration: 5.3 years (median) |
| SPS3, 2013 | less than 130 mm Hg (n=-9) vs. 130-149 mm Hg (n=-9) | patients lived in North America, Latin America, and Spain and had recent, MRI-defined symptomatic lacunar infarctions | open-label Parallel groups Sample size: -9/-9 Primary endpoint: FU duration: |
| Wei, 2013 | BP <=140/90 mm Hg (n=-9) vs. BP <=150/90 mm Hg (n=-9) | Chinese hypertensive patients older than 70 years | Parallel groups Sample size: -9/-9 Primary endpoint: FU duration: 4 years (mean) |
| PAST-BP, 2015 | (n=-9) vs. (n=-9) | | Sample size: -9/-9 Primary endpoint: FU duration: |
