Mechanism

treatment

comparator

Intensive blood pressure lowering strategies

hypertension, in all type of patients

Endpoint	TE [95% CI]	p val	n	k	trials
All cause death	0.89 [0.81 0.97]	p=0.04	36328	16	HOT, ABCD target (H) , AASK, REIN-2, ABCD target (N) , Toto, ACCORD blood pressure, Cardio-Sis, SPRINT, UKPDS-HDS, JATOS, VANLISH, HOMED-BP, SPS3, Wei, PAST-BP,
Cardiovascular death	0.84 [0.74 0.96]	p=0.04	35158	13	HOT, ABCD target (H) , AASK, REIN-2, ABCD target (N) , ACCORD blood pressure, SPRINT, UKPDS-HDS, JATOS, VANLISH, HOMED-BP, SPS3, Wei,
Heart failure	0.73 [0.61 0.87]	p=0.04	34891	9	HOT, ABCD target (H) , ABCD target (N) , ACCORD blood pressure, Cardio-Sis, SPRINT, UKPDS-HDS, JATOS, Wei,
Serious adverse event	2.04 [1.46 2.85]	p=0.04	5071	2	REIN-2, ACCORD blood pressure,
stroke (fatal and non fatal)	0.83 [0.73 0.96]	p=0.04	34855	11	HOT, ABCD target (H) , ABCD target (N) , ACCORD blood pressure, Cardio-Sis, SPRINT, UKPDS-HDS, JATOS, VANLISH, HOMED-BP, Wei,
myocardial infarction (fatal and non fatal)	0.86 [0.75 0.99]	p=0.04	16065	10	ABCD target (H) , ABCD target (N) , ACCORD blood pressure, Cardio-Sis, SPRINT, UKPDS-HDS, JATOS, VANLISH, HOMED-BP, Wei,
cardiovascular events	0.83 [0.77 0.89]	p=0.04	35931	13	HOT, ABCD target (H) , AASK, ABCD target (N) , ACCORD blood pressure, Cardio-Sis, SPRINT, UKPDS-HDS, JATOS, VANLISH, SPS3, Wei, PAST-BP,
End stage renal disease	0.85 [0.75 0.97]	p=0.04	16443	6	MDRD, AASK, REIN-2, Toto, ACCORD blood pressure, SPRINT,
non cardiovascular death	0.97 [0.78 1.19]	p=1.00	21172	5	HOT, ABCD target (H) , AASK, REIN-2, ABCD target (N) ,
left ventricular hypertrophy	0.67 [0.46 0.97]	p=0.04	967	1	Cardio-Sis,

TE: treatment effect; CI: confidence interval; k: nulmber of trials; n: total number of patients

Trial	Studied treatment	Control	Patients
MDRD, 1994	low target blood pressure (mean arterial pressure < 92 mm Hg)	usual target blood pressure (mean arterial pressure < 107 mm Hg)	patients with predominantly nondiabetic kidney disease and a glomerular filtration rate of 13 to 55 mL/min per 1.73 m2
HOT, 1994	less or equal than 85 mmHg, or less or equal than 80 mmHg	less or equal than 90 mmHg	patients with diastolic blood pressure between 100 mmHg and 115 mmHg
ABCD target (H) , 2000	intensive treatment with a diastolic blood pressure goal of 75 mmHg	moderate treatment with a diastolic blood pressure goal of 80-89 mmHg	diabetes patients with DBP >=90 mmHg
AASK, 2002	arterial pressure goal of 92 mm Hg or lower	usual mean arterial pressure goal of 102 to 107 mm Hg/pj	African-Americans,with diastolic blood pressure higher than 94mmHg and a glomerular filtration rate between 20 and 65 ml/min per 1.73 m2
REIN-2, 2005	intensified (systolic/diastolic <130/80 mm Hg) blood-pressure control	conventional (diastolic <90 mm Hg) blood-pressure control	patients with non-diabetic proteinuric nephropathies receiving background treatment with the ACE inhibitor ramipril
ABCD target (N) , 2002	intensive treatment (diastolic blood pressure decrease of 10 mmHg below baseline DBP)	moderate treatment (diastolic blood pressure goal of 80-89 mmHg)	diabetes patients with diastolic blood pressure between 80 and 89mmHg
Toto, 1995	strict blood pressure control (DBP 65 to 80 mm Hg)	usual blood pressure control (DBP 85 to 95 mm Hg)	non-diabetic patients (age 25 to 73) with long-standing hypertension (DBP > or = 95 mm Hg), chronic renal insufficiency (GFR < or = 70 m/min/1.73 m2) and a normal urine sediment
ACCORD blood pressure, 2008	intensive therapy, targeting a systolic pressure of less than 120 mm Hg	standard therapy, targeting a systolic pressure of less than 140 mm Hg	patients with a median glycated hemoglobin level of 8.1% at high risk for cardiovascular events
Cardio-Sis, 2009	tighter control of systolic BP with a goal of <130 mm Hg	usual control, with a goal of <140 mm Hg	nondiabetic patients with hypertension and with SBP of 150 mm Hg or higher confirmed at two different times
SPRINT, 2015	target of 120 mm Hg	target of 140 mm Hg	high-risk hypertensive adults 50 years of age and older with one additional cardiovascular risk factor or preexisting kidney disease
UKPDS-HDS, 1998	blood pressure of <150/85 mm Hg (with the use of an angiotensin converting enzyme inhibitor captopril or a beta blocker atenolol as main treatment)	less tight control aiming at a blood pressure of <180/105 mm Hg	patients with type 2 diabetes
JATOS, 2008	strict treatment to maintain systolic blood pressure below 140 mmHg	mild treatment to maintain systolic blood pressure below 160 but at or above 140 mmHg	elderly hypertensive patients with essential hypertension (65-85 years old, with a pretreatment systolic blood pressure of above 160 mmHg)
VANLISH, 2010	strict blood pressure control (<140 mm Hg)	moderate blood pressure control (> or =140 mm Hg to <150 mm Hg)	patients aged 70 to 84 years with isolated systolic hypertension (sitting blood pressure 160 to 199 mm Hg)
HOMED-BP, 2012	tight control (<125/<80 mm Hg (TC)) of HBP	usual control (125-134/80-84 mm Hg (UC))	with an untreated systolic/diastolic HBP of 135-179/85-119 mm Hg
SPS3, 2013	less than 130 mm Hg	130-149 mm Hg	patients lived in North America, Latin America, and Spain and had recent, MRI-defined symptomatic lacunar infarctions
Wei, 2013	BP <=140/90 mm Hg	BP <=150/90 mm Hg	Chinese hypertensive patients older than 70 years
PAST-BP, 2015

Intensive blood pressure lowering strategies

hypertension, in non diabetic patients

Endpoint	TE [95% CI]	p val	n	k	trials
All cause death	0.90 [0.79 1.03]	p=1.00	29677	5	HOT, REIN-2, Toto, Cardio-Sis, SPRINT,
Cardiovascular death	0.89 [0.72 1.10]	p=1.00	28489	3	HOT, REIN-2, SPRINT,
Heart failure	0.64 [0.49 0.84]	p=0.04	29262	3	HOT, Cardio-Sis, SPRINT,
Serious adverse event	1.39 [0.81 2.39]	p=1.00	338	1	REIN-2,
stroke (fatal and non fatal)	0.98 [0.80 1.19]	p=1.00	29262	3	HOT, Cardio-Sis, SPRINT,
myocardial infarction (fatal and non fatal)	0.82 [0.64 1.06]	p=1.00	10472	2	Cardio-Sis, SPRINT,
cardiovascular events	0.83 [0.75 0.93]	p=0.04	29262	3	HOT, Cardio-Sis, SPRINT,
End stage renal disease	0.81 [0.69 0.95]	p=0.04	10616	4	MDRD, REIN-2, Toto, SPRINT,
non cardiovascular death	1.06 [0.84 1.35]	p=1.00	19128	2	HOT, REIN-2,
left ventricular hypertrophy	0.67 [0.46 0.97]	p=0.04	967	1	Cardio-Sis,

TE: treatment effect; CI: confidence interval; k: nulmber of trials; n: total number of patients

Trial	Studied treatment	Control	Patients
MDRD, 1994	low target blood pressure (mean arterial pressure < 92 mm Hg)	usual target blood pressure (mean arterial pressure < 107 mm Hg)	patients with predominantly nondiabetic kidney disease and a glomerular filtration rate of 13 to 55 mL/min per 1.73 m2
HOT, 1994	less or equal than 85 mmHg, or less or equal than 80 mmHg	less or equal than 90 mmHg	patients with diastolic blood pressure between 100 mmHg and 115 mmHg
REIN-2, 2005	intensified (systolic/diastolic <130/80 mm Hg) blood-pressure control	conventional (diastolic <90 mm Hg) blood-pressure control	patients with non-diabetic proteinuric nephropathies receiving background treatment with the ACE inhibitor ramipril
Toto, 1995	strict blood pressure control (DBP 65 to 80 mm Hg)	usual blood pressure control (DBP 85 to 95 mm Hg)	non-diabetic patients (age 25 to 73) with long-standing hypertension (DBP > or = 95 mm Hg), chronic renal insufficiency (GFR < or = 70 m/min/1.73 m2) and a normal urine sediment
Cardio-Sis, 2009	tighter control of systolic BP with a goal of <130 mm Hg	usual control, with a goal of <140 mm Hg	nondiabetic patients with hypertension and with SBP of 150 mm Hg or higher confirmed at two different times
SPRINT, 2015	target of 120 mm Hg	target of 140 mm Hg	high-risk hypertensive adults 50 years of age and older with one additional cardiovascular risk factor or preexisting kidney disease

Intensive blood pressure lowering strategies

hypertension, in patients with chronic kidney disease

Intensive blood pressure lowering strategies

hypertension, in diabetic patients

intensive blood pressure control