Effect of intensive blood pressure control in patients with resistant hypertension: insights from the STEP trial
Primary result · Composite of CV events, resistant hypertension subgroupResult — go to the resultHazard ratio 0.36 95% CI 0.14–0.93Authors' conclusion
Intensive BP control is associated with reduced risk of cardiovascular events in patients with resistant hypertension without increased risk of adverse events.
Study context
- Population
- Older hypertensive patients in the STEP trial with resistant hypertension (uncontrolled blood pressure (BP) on ≥3 antihypertensive drugs or controlled BP on ≥4)
- Comparison
- Intensive vs standard BP control in resistant hypertension
- Primary endpoint
- Composite of CV events
Primary result
As reported in the abstract
Composite of:
- CV events
- Resistant hypertension subgroup
Hazard ratio
0.36
95% CI 0.14–0.93
P = 0.035
Intensive vs Standard
HR 0.36 (95% CI 0.14–0.93); P = 0.035
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| CV risk, resistant vs no resistant hypertension | 1.78 (1.13–2.81) | P = 0.012 | |
| 0.20.5125Hazard ratio (log scale) |
Safety
Adverse events, resistant hypertension subgroup
- Intensive BP control not associated with increased risk of adverse events
Original publication
Effect of intensive blood pressure control in patients with resistant hypertension: insights from the STEP trial. Eur J Prev Cardiol. Published 12 August 2025. doi:10.
Summarised from the published abstract; every number is checked against it