Effect of intensive versus standard blood pressure control on cardiovascular outcomes: a meta-analysis of randomized controlled trials

BACKGROUND: This meta-analysis systematically evaluated the impact of intensive (typically targeting systolic BP [SBP] <120 or <130 mmHg) versus standard (typically targeting SBP <140 mmHg) blood pressure control on cardiovascular outcomes in patients with hypertension. MATERIALS AND METHODS: Relevant randomized controlled trials (RCTs) published up to May 2025 were identified through systematic searches of PubMed, Embase, Web of Science, and the Cochrane Library. A random-effects model was used to calculate pooled relative risks (RRs) with 95% confidence intervals (CIs). RESULTS: < 0.001). Sensitivity analyses confirmed the robustness of these findings. Additionally, the treatment effects varied by sample size, male proportion, smoking prevalence, diabetes status, and follow-up duration. CONCLUSION: Intensive blood pressure control (typically targeting SBP <120 or <130 mmHg) is strongly associated with a reduced risk of cardiovascular events. These findings support adopting lower blood pressure targets in clinical practice while emphasizing the need for individualized patient assessment.