Compared to standard blood pressure (BP) targets (≤140- 160/90-100mmHg), how effective are lower BP targets (≤135/85mmHg) in reducing mortality and morbidity?
All of the identified trials assessed diastolic or mean blood pressure targets, and none of the trials compared different targets for systolic blood pressure. Therefore, at present we have no information regarding the benefits or harms of trying to achieve "lower systolic blood pressure targets" as compared with "standard systolic blood pressure targets". The main potential source of bias in this meta-analysis is inevitable because the intervention of trying to achieve a target blood pressure cannot be blinded. Another limitation of this meta-analysis is that one single trial provided most of the participants and outcome data. Selective reporting bias is also a significant source of bias in this metaanalysis, as in some trials certain outcomes were not reported.
When treating elevated BP, doctors need to know what BP target they should try to achieve. The standard of clinical practice for some time has been ≤140-160/90-100mmHg. New guidelines are recommending BP targets lower than this standard.