The Study
Systolic blood pressure targets below 120 mm Hg are associated with reduced mortality: A meta‐analysis
This study looked at many big experiments where people were randomly assigned to try to lower their blood pressure more or less. It found that people who tried harder to get their blood pressure very low had fewer heart problems and lived longer—but it’s not 100% sure because the doctors and patients knew which group they were in, which might have changed how they acted.
Analysis score
Maximum 100 for a systematic review with meta-analysis.
Where the score came from
Doctors tried to lower blood pressure even more than usual in people at high risk for heart problems to see if it would help them live longer.
Where does this study sit?
Reviews of RCTs (Meta-analyses)
Max 100Randomized Trials
Max 90Reviews of Cohort Studies
Max 85Cohort Studies
Max 72Reviews of Case-Control Studies
Max 63Case-Control Studies
Max 58Cross-Sectional & Case Series
Max 50Expert Opinion
Max 566 / 100
Quality score
The highest quality evidence. Systematic reviews and meta-analyses that pool randomized controlled trials, giving the most reliable summary of experimental evidence.
Key takeaways
Summary
Based on the study abstract and findings.
- 1The benefit is small: you'd need to treat 185 people for 4 years to prevent one death, but many more would suffer side effects like fainting or kidney issues.
- 2People with blood pressure under 120 had 13% fewer deaths, 17% fewer heart attacks, and 27% fewer heart-related deaths—but also 234% more fainting spells and 166% more kidney problems.
Score breakdown, methodology, conflicts of interest, evidence analysis & raw study data
Publication
Journal
Journal of Internal Medicine
Year
2025
Authors
Felix Bergmann, Marlene Prager, Lena Pracher, Rebecca Sawodny, Gloria M Steiner-Gager, B. Richter, Bernd Jilma, M. Zeitlinger, Georg Gelbenegger, Anselm Jorda
Related Content
Claims (6)
In adults at high risk for heart disease, lowering systolic blood pressure to below 120 mm Hg instead of below 140 mm Hg is linked to a 13% lower rate of death from any cause over about four years, but it also increases the risk of low blood pressure, fainting, and kidney injury.
In adults with high cardiovascular risk, lowering systolic blood pressure to below 120 mm Hg instead of below 140 mm Hg is associated with higher rates of syncope, acute kidney injury, and electrolyte abnormalities.
For adults at higher risk of heart disease, lowering systolic blood pressure to below 120 mm Hg reduces deaths and serious heart events consistently, regardless of age, sex, diabetes status, or prior heart disease.
When systolic blood pressure rises by 20 mm Hg, the risk of dying from heart or blood vessel disease doubles, and this increased risk starts even at blood pressure levels as low as 115 mm Hg.
In adults at higher risk for heart problems, lowering systolic blood pressure to under 120 mm Hg instead of under 140 mm Hg is linked to lower rates of heart attacks, strokes, and death from cardiovascular causes.
In adults with high cardiovascular risk, the observed link between lowering systolic blood pressure below 120 mm Hg and lower death rates depends entirely on one major study called SPRINT; without that study, the link disappears.
Not medical advice. For informational purposes only. Always consult a qualified healthcare professional before making health decisions.