Evidence map›Paper›PMID 30948832›Full record

SynthesisHypertension research : official journal of the Japanese Society of Hypertension2019

Target blood pressure level for the treatment of elderly hypertensive patients: a systematic review and meta-analysis of randomized trials.

Yoichi Takami, Koichi Yamamoto, Hisatomi Arima, Atsushi Sakima

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Hypertension research : official journal of the Japanese Society of Hypertension, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 3 pooled it
1.9field-weighted citation impact, top 13% of its field
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

13 citing papers in PubMed, 3 syntheses or guidelines pooled it, 19 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. The Japanese Society of Hypertension Guidelines for the Management of Hypertension (JSH 2019).Hypertension research : official journal of the Japanese Society of Hypertension · 2019
    Guideline
  4. Article
  5. The Japanese Society of Hypertension Guidelines for the management of elevated blood pressure and hypertension 2025 (JSH2025).Hypertension research : official journal of the Japanese Society of Hypertension · 2026
    Article
  6. Review
  7. Article
  8. Review
  9. Article
  10. Step for breaking free from clinical inertia.Hypertension research : official journal of the Japanese Society of Hypertension · 2022
    Article
  11. Numbers and Mortality Risk of Hypertensive Patients with or without Elevated Body Mass Index in China.International journal of environmental research and public health · 2021
    Article
  12. Review
  13. Review
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

4 authors at 3 institutions in 1 country.

Yoichi TakamiDepartment of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.
Koichi YamamotoDepartment of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Osaka, Japan. kyamamoto@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, Nishihara-cho, Okinawa, Japan.
Osaka University · JPFukuoka University · JPUniversity of the Ryukyus · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Although recent systematic reviews (SRs) of randomized clinical trials (RCTs) support the benefit of blood pressure (BP) treatment in the elderly, the optimized target BP level remains controversial. We performed a SR to determine the clinical benefit of antihypertensive treatments with a target systolic BP (SBP) of <140 mmHg in the elderly. We searched for RCTs comparing intensive and less intensive treatments or placebo and active treatments reported until May 2017 and identified 11 RCTs in which the target or on-treatment SBP in the intensive or active treatment was less than 140 mmHg. Among the RCTs, 6 RCTs with primary or subanalysis results for patients aged 70 years or older were finally chosen for the meta-analysis. We found that intensive lowering of BP did not reduce the risk ratio (RR) of composite cardiovascular outcomes (95% CI: 0.67-1.05, p = 0.13). By contrast, intensive lowering of BP achieved RR reductions of 24% for all-cause death (0.63-0.92) and of 39% for cardiovascular death (0.48-0.77). Intensive lowering of BP did not alter the incidence of stroke (0.63-1.23) and serious adverse events (SAEs) (0.93-1.09). In conclusion, intensive antihypertensive regimens targeting SBP < 140 mmHg did not significantly reduce the risk of cardiovascular diseases compared to that of less intensive treatments, but did reduce the risk of death without increasing adverse events in patients aged 70 years or older. These findings support the benefit of intensive treatment targeting SBP to ≤140 mmHg in the elderly.

Indexed as

AgedAntihypertensive AgentsBlood PressureHumansHypertensionRandomized Controlled Trials as TopicAntihypertensive AgentsHypertensionMeta-analysisRandomized clinical trialSystematic reviewThe elderly

Identifiers

PMID30948832
OpenAlexW2927083207

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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 OpenQuestion graph.