Optimal Systolic Blood Pressure Target in Resistant Hypertension

Pooled analysis of the ACCORD and SPRINT studies showed that in participants with uncontrolled apparent treatment-resistant hypertension, targeting systolic blood pressure (mm Hg) target <120 vs <140 reduced composite cardiovascular outcomes.1 As the authors noted, previous observational studies did not report expected benefits for one or more cardiovascular outcomes when comparing patients with controlled and uncontrolled apparent treatment-resistant hypertension. Given greater weighting of randomized, prospective studies than observational reports, the pooled analysis appears to support the authors’ conclusion that adults with and without apparent treatment-resistant hypertension benefit from more intensive blood pressure targets.