Optimal blood pressure target in patients with uncomplicated hypertension: a target trial emulation study
- Ran Zhang
- Ivan Chun Hang Lam
- Louise Emilsson
- Feng Sun
- Siyan Zhan
- Kai Hang Yiu
- Daniel Yee Tak Fong
- Esther Yee Tak Yu
- Celine Sze Ling Chui
- Esther Wai Yin Chan
- Ian Chi Kei Wong
- Cindy Lo Kuen Lam
- Goodarz Danaei
- Eric Yuk Fai Wan
2026-06-05
The limited real-world evidence on the clinical benefits of intensive blood pressure (BP) management demonstrated in randomised controlled trials has led to its poor adoption in primary care settings. Here we conducted a target trial emulation study on 118,271 patients with uncomplicated hypertension to evaluate the effectiveness and safety managed by intensive (below 130/80 mmHg) compared to standard (130-140/80-90 mmHg) BP targets using a territory-wide public healthcare database in Hong Kong. Patients in the intensive blood pressure target group were observed to incur a lower risk of hypertension related complications and all-cause mortality with no significant increased risk of the serious adverse events reported. The findings of this study provide evidence on the clinical benefits of an intensive BP management in real-world settings, supporting the adoption of a BP target of less than 130/80 mmHg in clinical guidelines for the treatment of adult patients with hypertension in primary care.