Reply'Is low blood pressure the cause of an adverse outcome or an effect of the extended cardiovascular disease in the prognostic value of the blood pressure in ONTARGET trial?'

摘要

We thank Drs Kotsis and Stabouli for their interest in our analysis, and the points they raise - several of which are discussed in our publication under 'Limitations'.The future risk in our patients was not low, nor was the follow-up period limited (approximately 5 years) in comparison with other studies. The study provides enough power to assess whether the blood pressure (BP) reduction reduces risk in these very high-risk patients.The main point of our article was to question the evidence base for the current guidelines - which advise lower blood pressure targets in patients at higher risk. Several groups have recently suggested that there is a need for better randomized studies of BP reduction from starting levels below 150-160 mmHg systolic BP [1].