Age-stratified and blood-pressure-stratified effects of blood-pressure-lowering pharmacotherapy for the prevention of cardiovascular disease and death: an individual participant-level data meta-analysis
Kazem Rahimi,Zeinab Bidel,Milad Nazarzadeh,Emma Copland,Dexter Canoy,Malgorzata Wamil,Jeannette Majert,Richard J McManus,Amanda I Adler,Larry Agodoa,Ale Algra,Folkert W. Asselbergs,N Beckett,Eivind Berge,Henry R. Black,Eric Boersma,Frank P. Brouwers,Morris J. Brown,Jasper J Brugts,Christopher J. Bulpitt,Robert P Byington,William C. Cushman,Jeffrey Cutler,Richard B Devereaux,Jamie P. Dwyer,Ray Estacio,Robert Fagard,Kim Fox,Tsuguya Fukui,Ajay Gupta,Rury R. Holman,Yutaka Imai,Masao Ishii,Stevo Julius,Yoshihiko Kanno,Sverre E. Kjeldsen,John B. Kostis,Kizuku Kuramoto,Jan Lanke,Edmund J. Lewis,Julia B. Lewis,Michel Lievre,Lars H Lindholm,Stephan Lueders,Stephen MacMahon,Giuseppe Mancia,Masunori Matsuzaki,Maria H Mehlum,Steven E. Nissen,Hiroshi Ogawa,Toshio Ogihara,Takayoshi Ohkubo,Christopher R. Palmer,Anushka Patel,MA Pfeffer,Bertram Pitt,Neil R Poulter,Hiromi Rakugi,Gianpaolo Reboldi,Christopher M. Reid,Giuseppe Remuzzi,Piero Ruggenenti,Takao Saruta,Joachim Schrader,Robert W. Schrier,Peter S. Sever,Peter Sleight,Jan A. Staessen,Hiromichi Suzuki,Lutgarde Thijs,Kenji Ueshima,Seiji Umemoto,Wiek H. van Gilst,Paolo Verdecchia,Kristian Wachtell,Paul K. Whelton,Lindon Wing,Mark Woodward,Yoshiki Yui,Salim Yusuf,Alberto Zanchetti,Zhen-Yu Zhang,Craig S. Anderson,Colin Baigent,Barry M. Brenner,Rory Collins,Dick de Zeeuw,Jacobus Lubsen,Ettore Malacco,Bruce Neal,Vlado Perkovic,Anthony Rodgers,Peter M. Rothwell,Gholamreza Salimi-Khorshidi,Johan Sundström,Fiona Turnbull,Giancarlo Viberti,Ji-Guang Wang,John Chalmers,Barry R. Davis,Carl J. Pepine,Koon K. Teo +101 more
TLDR
Pharmacological blood pressure reduction is effective into old age, with no evidence that relative risk reductions for prevention of major cardiovascular events vary by systolic or diastolic blood pressure levels at randomisation, down to less than 120/70 mm Hg.About:
This article is published in The Lancet.The article was published on 2021-09-18 and is currently open access. It has received 109 citations till now. The article focuses on the topics: Blood pressure & Absolute risk reduction.read more
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Long-term efficacy and safety of renal denervation in the presence of antihypertensive drugs (SPYRAL HTN-ON MED): a randomised, sham-controlled trial
TL;DR: The SPYRAL HTN-ON MED trial as discussed by the authors compared changes in blood pressure, antihypertensive drug use, and safety up to 36 months in renal denervation versus a sham control group.
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Seven‐action approaches for the management of hypertension in Asia – The HOPE Asia network
Kazuomi Kario,Yook Chin Chia,Saulat Siddique,Yuda Turana,Yang Li,Chen Chen,Jennifer Nailes,Minh Van Huynh,Peera Buranakitjaroen,Hao Min Cheng,Takeshi Fujiwara,Satoshi Hoshide,Michiaki Nagai,Sungha Park,Jinho Shin Shin,Jorge Sison,Arieska Ann Soenarta,Guru Prasad Sogunuru,Apichard Sukonthasarn,Jam Chin Tay,Boon Wee Teo,Kelvin K.F. Tsoi,Narsingh Verma,Tzung-Dau Wang,Yuqing Zhang,Ji-Guang Wang +25 more
TL;DR: This consensus document of HOPE Asia Network introduces seven action approaches for management of hypertension in Asia and explains the rationale for choosing an Asia‐specific approach to hypertension management.
Journal ArticleDOI
Time to Clinical Benefit of Intensive Blood Pressure Lowering in Patients 60 Years and Older With Hypertension
Tao Chen,Fang Shao,Kangyu Chen,Yang Wang,Zhenqiang Wu,Yongjuan Wang,Yanpei Gao,Victoria Cornelius,Chao Li,Zhixin Jiang +9 more
TL;DR: This secondary analysis of randomized clinical trials estimates the time needed to potentially derive clinical benefit from intensive blood pressure treatment in patients 60 years and older.
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Treatment of Resistant Hypertension With Endovascular Baroreflex Amplification: 3-Year Results From the CALM-FIM Study.
M E A M Van Kleef,Chandan Devireddy,Jan Van der Heyden,Mark C. Bates,George L. Bakris,Gregg W. Stone,Bryan Williams,Wilko Spiering +7 more
TL;DR: In this paper , the authors evaluated the long-term safety and effectiveness of endovascular baroreflex amplification (EVBA) from both the European and American CALM-FIM cohorts.
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Longer-Term All-Cause and Cardiovascular Mortality With Intensive Blood Pressure Control: A Secondary Analysis of a Randomized Clinical Trial.
Byron C. Jaeger,Adam P. Bress,Joshua D. Bundy,Alfred K. Cheung,William C. Cushman,Paul E. Drawz,Karen C. Johnson,Cora E. Lewis,Suzanne Oparil,Michael V. Rocco,Stephen R. Rapp,Mark A. Supiano,Paul K. Whelton,Jeff D. Williamson,Jackson T. Wright,David M. Reboussin,Nicholas M. Pajewski +16 more
TL;DR: The beneficial effect of intensive treatment on cardiovascular and all-cause mortality did not persist after the SPRINT trial, and the importance of consistent long-term management of hypertension is highlighted.
References
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Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies.
TL;DR: Throughout middle and old age, usual blood pressure is strongly and directly related to vascular (and overall) mortality, without any evidence of a threshold down to at least 115/75 mm Hg.
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2018 ESC/ESH Guidelines for the management of arterial hypertension.
B. Williams,G. Mancia,Wilko Spiering,Agabiti Rosei E,M. Azizi,Michel Burnier,Denis Clement,A. Coca,de Simone G,A Dominiczak,T. Kahan,Felix Mahfoud,Josep Redon,L.M. Ruilope,Alberto Zanchetti,Mary Kerins,S.E. Kjeldsen,Reinhold Kreutz,S. Laurent,Lip Gyh.,Richard J McManus,Krzysztof Narkiewicz,Frank Ruschitzka,R.E. Schmieder,Evgeny Shlyakhto,Constantinos Tsioufis,Aboyans,Ileana Desormais +27 more
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Renoprotective Effect of the Angiotensin-Receptor Antagonist Irbesartan in Patients with Nephropathy Due to Type 2 Diabetes
Edmond J Lewis,Lawrence G. Hunsicker,William R. Clarke,Tomas Berl,Marc A. Pohl,Julia B. Lewis,Eberhard Ritz,Robert C. Atkins,Richard D. Rohde,Itamar Raz +9 more
TL;DR: The angiotensin-II-receptor blocker irbesartan is effective in protecting against the progression of nephropathy due to type 2 diabetes, independent of the reduction in blood pressure it causes.
Journal ArticleDOI
Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: The antihypertensive and lipid-lowering treatment to prevent heart attack trial (ALLHAT)
Curt D. Furberg,Jackson T. Wright,Barry R. Davis,Jeffrey A. Cutler,Michael H. Alderman,Henry R. Black,William C. Cushman,Richard H. Grimm,L. Julian Haywood,Frans H. H. Leenen,Suzanne Oparil,Jeffrey L. Probstfield,Paul K. Whelton,Chuke Nwachuku,David Gordon,Michael A. Proschan,Paula Einhom,Charles E. Ford,Linda B. Piller,I. Kay Dunn,David C. Goff,Sara L. Pressel,Judy Bettencourt,Barbara DeLeon,Lara M. Simpson,Joe Blanton,Therese S. Geraci,Sandra M. Walsh,Christine Nelson,Mahboob Rahman,Anne Juratovac,Robert Pospisil,Lillian Carroll,Sheila Sullivan,Jeanne Russo,Gail Barone,Rudy Christian,Sharon Feldman,Tracy Lucente,David A. Calhoun,Kim Jenkins,Peggy McDowell,Janice Johnson,Connie Kingry,Juan Alzate,Karen L. Margolis,Leslie Ann Holland-Klemme,Brenda Jaeger,Jeff D. Williamson,Gail T. Louis,Pamela Ragusa,Angela Williard,R. L Sue Ferguson,Joanna Tanner,John H. Eckfeldt,Richard S. Crow,John Pelosi +56 more
TL;DR: Thiazide-type diuretics are superior in preventing 1 or more major forms of CVD and are less expensive and should be preferred for first-step antihypertensive therapy.
Journal ArticleDOI
A Randomized Trial of Intensive versus Standard Blood-Pressure Control
Jackson T. Wright,Jeff D. Williamson,Paul K. Whelton,Joni K. Snyder,Kaycee M. Sink,Michael V. Rocco,David M. Reboussin,Mahboob Rahman,Mahboob Rahman,Suzanne Oparil,Cora E. Lewis,Paul L. Kimmel,Karen C. Johnson,David C. Goff,Lawrence J. Fine,Jeffrey A. Cutler,William C. Cushman,Alfred K. Cheung,Walter T. Ambrosius +18 more
TL;DR: In this article, the most appropriate targets for systolic blood pressure to reduce cardiovascular morbidity and mortality among persons without diabetes remain uncertain, and the authors propose a target of less than 120 mm Hg.