Intensive reduction of blood pressure in hypertensive patients can be achieved and helps reduce illness, according to the findings of a major global analysis.
British experts said the research suggested benefits for identifying high risk patients for this intensive treatment.
The research, reported in The Lancet involved a metanalysis of 19 trials involving nearly 45,000 patients.
The researchers say that intensive treatment reduced heart attacks by 14% and cases of stroke by about 25%. The benefits were the most in trials of patients with pre-existing vascular disease, kidney disease or diabetes.
The research also showed that on average programmes of intensive treatment achieved blood pressure levels of 133.2/76.4 mmHg compared with 140.4/80.9 mmHg for standard treatments.
Intensive treatments trebled the rate of hypotension – low blood pressure – but there was no evidence of increased drop-out rates.
Researcher Professor Anthony Rodgers, of The George Institute of Global Health, Sydney, Australia, said the findings challenge recent clinical guidelines setting blood pressure targets at 140/90 mmHg.
He said: "Our robust evidence clearly shows that treating blood pressure to a lower level than currently recommended targets results in better health outcomes for patients.”
He added: "Much more research is needed to determine how best to easily and safely achieve and maintain greater blood pressure reductions. Improving treatment rates and long-term adherence is critical for the success of any intervention.
"Patients are also likely to benefit non-drug approaches such as weight loss and restricting salt intake.”
But Christopher Allen, of the British Heart Foundation, said: “For most people a blood pressure of less than 140/90mmHg is acceptable, but this large trial suggests that some people at higher risk might benefit from more intensive treatment to bring their blood pressure even lower.
"If we were able to identify these individuals and treat them appropriately we could potentially save more lives however further analysis is needed if current guidelines are to be reviewed."
Effects of intensive blood pressure lowering on cardiovascular and renal outcomes: updated systematic review and meta-analysis. Lancet 6 November 2015 [abstract]
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