Evidence mapPaperPMID 40790093Full record

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.

Yoichi Nozato, Yume Nohara-Shitama, Takuro Kubozono, Hiroshi Akasaka, Yoichi Takami, Hisatomi Arima, Atsushi Sakima, Koichi Yamamoto

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

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.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. JSH2025 guidelines for hypertension management in older adults: international comparison.Hypertension research : official journal of the Japanese Society of Hypertension · 2026
    Article
  5. Article
  6. Advancing evidence-based blood pressure targets in JSH2025.Hypertension research : official journal of the Japanese Society of Hypertension · 2026
    Article
  7. Article
  8. 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 · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Yoichi NozatoDepartment of Geriatric and General Medicine, The University of Osaka, Graduate School of Medicine, Osaka, Japan. yoichi.nozato@geriat.med.osaka-u.ac.jp.
Yume Nohara-ShitamaDivision of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Fukuoka, Japan.
Takuro KubozonoDepartment of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
Hiroshi AkasakaDepartment of Geriatric and General Medicine, The University of Osaka, Graduate School of Medicine, Osaka, Japan.
Yoichi TakamiDepartment of Geriatric and General Medicine, The University of Osaka, Graduate School of Medicine, Osaka, Japan. takami@geriat.med.osaka-u.ac.jp.
Hisatomi ArimaDepartment of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
Atsushi SakimaHealth Administration Center, University of the Ryukyus, Okinawa, Japan.
Koichi YamamotoDepartment of Geriatric and General Medicine, The University of Osaka, Graduate School of Medicine, Osaka, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

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.

Indexed as

Antihypertensive AgentsBlood PressureHypertensionAgedAged, 80 and overHumansAntihypertensive AgentsImplemental hypertensionMeta-analysisOlder peopleRandomized controlled trialSystematic review

Identifiers

PMID40790093
PMCPMC12497641

What Socratic holds

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LicenceCC BY
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Registered trials

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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.