Brunström M, et al. - In this systematic review and meta-analysis of randomized placebo-controlled trials (n = 18) of 92,567 individuals with ≥ 1,000 patient-years of follow-up, matching any antihypertensive agent with placebo, experts evaluated the impact of antihypertensive treatment in the 130–140 mm Hg systolic blood pressure range. Primary preventive antihypertensive treatment was related to a neutral impact on all-cause mortality and major cardiovascular events, although, with an increased risk of discontinuation because of adverse events. Though the risk of hypotension-related adverse events rose with treatment, none of the secondary efficiency outcomes were significantly decreased. Antihypertensive treatment in coronary artery disease secondary prevention was correlated with diminished risk of all-cause mortality and major cardiovascular events, however, it doubled the risk of adverse events resulting in discontinuation. Hence, in the 130–140 mm Hg systolic blood pressure range, primary preventive blood pressure-lowering contributes no cardiovascular advantage although it raises the risk of adverse events. Moreover, in secondary prevention, advantages should be weighed in contrary to the disadvantages.