SynthesisHypertension research : official journal of the Japanese Society of Hypertension2025
Targeting a systolic blood pressure of <130 mmHg is beneficial in adults with hypertension aged ≥75 years: a systematic review and meta-analysis.
Synthesis in Hypertension research : official journal of the Japanese Society of Hypertension, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Angiotensin Receptor Blockers Versus Calcium Channel Blockers for First-Line Antihypertensive Therapy and Survival in Adults Aged 75 Years or Older.Journal of the American Geriatrics Society · 2026Article
- Prevalence and factors associated with uncontrolled systolic blood pressure among treated older adults in Sri Lanka: a nationwide multicenter cross-sectional study.BMC cardiovascular disorders · 2026Article
- Consensus statement on practical guidance for optimizing antihypertensive therapy in older adults needing nursing care by the Japan Geriatrics Society and the Japanese Society of Hypertension: English translation of the Japanese article.Hypertension research : official journal of the Japanese Society of Hypertension · 2026Article
- JSH2025 guidelines for hypertension management in older adults: international comparison.Hypertension research : official journal of the Japanese Society of Hypertension · 2026Article
- Consensus Statement on Practical Guidance for Optimizing Antihypertensive Therapy in Older Adults Needing Nursing Care by the Japan Geriatrics Society and the Japanese Society of Hypertension: English Translation of the Japanese Article.Geriatrics & gerontology international · 2026Article
- Advancing evidence-based blood pressure targets in JSH2025.Hypertension research : official journal of the Japanese Society of Hypertension · 2026Article
- The conservative-challenging paradigm of antihypertensive therapy in JSH2025: a comparative perspective with contemporary Western guidelines.Hypertension research : official journal of the Japanese Society of Hypertension · 2026Article
- The new blood pressure target, a new era: individualized management and precision rooted in clinical decision in JSH2025.Hypertension research : official journal of the Japanese Society of Hypertension · 2025Article
Corrections and comments
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Authors and funding
8 authors.
Funding
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Abstract
Recent clinical trials have raised important questions regarding optimal blood pressure (BP) targets in older adults with hypertension. In the 2019 Japanese Society of Hypertension guidelines, a systolic BP (SBP) target of <140 mmHg is recommended for individuals aged ≥75 years. However, subsequent randomized controlled trials (RCTs) have shown potential cardiovascular and mortality benefits associated with strict BP targets. We conducted an updated systematic review and meta-analysis to evaluate the efficacy and safety of intensive SBP control (<130 mmHg) compared with less intensive control (≥130 mmHg) in patients with hypertension aged ≥75 years. We searched MEDLINE, Cochrane Library, and Ichushi Web for publications up to May 30, 2024, supplemented by manual searches. Seven RCTs that met predefined eligibility criteria were included in the final meta-analysis. Among patients aged ≥75 years, intensive SBP lowering was associated with significantly reduced risks of composite cardiovascular events (risk ratio [RR]: 0.61, 95% confidence interval [CI]: 0.40-0.94, p = 0.03), all-cause mortality (RR: 0.72, 95% CI: 0.56-0.93, p = 0.01), and cardiovascular mortality (RR: 0.55, 95% CI: 0.35-0.88, p = 0.01), with no increase in serious adverse events (RR: 1.00, 95% CI: 0.93-1.08, p = 0.97). Stroke incidence did not differ significantly between groups. Similar results were observed when the analysis was expanded to include studies that enrolled participants aged ≥70 years. These findings support the safety and clinical benefits of targeting an SBP of <130 mmHg in older adults with hypertension.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.