Systematic review: blood pressure target in @entity740 and XXXX as an effect modifier.

@entity1 @entity644 @entity6 @entity740 @entity177
BACKGROUND: The optimal blood pressure target in @entity1 with @entity740 ( @entity740 ) is unclear. PURPOSE: To summarize trials comparing lower versus higher blood pressure targets in adult @entity1 with @entity740 and focus on @entity644 as an effect modifier. DATA SOURCES: MEDLINE and the Cochrane Central Register of Controlled Trials (July 2001 through January 2011) were searched for reports from randomized, controlled trials with no language restriction. STUDY SELECTION: Authors screened abstracts to identify reports from trials comparing blood pressure targets in adults with @entity740 that had more than 50 @entity1 per group; at least 1-year follow-up; and outcomes of @entity177 , cardiovascular events, change in kidney function, number of antihypertensive agents, and adverse events. DATA EXTRACTION: Reviewers extracted data on study design, methods, sample characteristics, interventions, comparators, outcomes, number of medications, and adverse events and rated study quality and quality of analyses for @entity644 subgroups. DATA SYNTHESIS: Three trials with a total of 2272 @entity1 were included. Overall, trials did not show that a blood pressure target of less than 125/75 to 130/80 mm Hg is more beneficial than a target of less than 140/90 mm Hg. Lower-quality evidence suggests that a low target may be beneficial in subgroups with @entity644 greater than 300 to 1000 mg/d. @entity1 in the low target groups needed more antihypertensive medications and had a slightly higher rate of adverse events. LIMITATIONS: No study included @entity1 with @entity6 . Trial duration may have been too short to detect differences in clinically important outcomes, such as @entity177 . Ascertainment and reporting of adverse events was not uniform. CONCLUSION: Available evidence is inconclusive but does not prove that a blood pressure target of less than 130/80 mm Hg improves clinical outcomes more than a target of less than 140/90 mm Hg in adults with @entity740 . Whether a lower target benefits @entity1 with @entity644 greater than 300 to 1000 mg/d requires further study.
