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Systolic blood pressure targets


Authors: Miroslav Souček
Authors‘ workplace: II. interní klinika LF MU a ICRC FN u sv. Anny v Brně
Published in: Vnitř Lék 2016; 62(7-8): 635-639
Category: Reviews

Overview

When treating systolic hypertension we do not know the optimum blood pressure which leads to the reduction of cardiovascular events and cardiovascular and total mortality. The results of the ACCORD study, when comparing intensive treatment of systolic blood pressure (SBP) < 120 mm Hg and standard treatment < 140 mm Hg, did not lead to affecting the primary target for patients with diabetes mellitus. The SPRINT study (Systolic Blood Pressure Intervention Trial) has shown that more intensive treatment of hypertension (aimed at readings lower than the generally recommended target readings) significantly reduces incidence of cardiovascular diseases and lowers the risk of death. On the other hand, a statistically significant incidence of side effects (hypotension, syncope, renal impairment or failure) has been identified. The first results were presented at the American Heart Association Congress on 9 November 2015.

Key words:
target values – hypotension – cardiovascular events – systolic blood pressure


Sources

1. Franklin SS, Jacobs MJ, Wong ND et al. Predominance of isolated systolic hypertension among middle-aged and elderly US hypertensives: analysis based on National Health and Nutrition Examination Survey (NHANES) III. Hypertension 2001; 37(3): 869–874.

2. Chobanian AV, Bakris GL, Black HR et al. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 Report. JAMA 2003; 289(19): 2560–2572.

3. Hsu CY, McCulloch CE, Darbinian J et al. Elevated blood pressure and risk of end-stage renal disease in subjects without baseline kidney disease. Arch Intern Med 2005; 165(8): 923–928.

4. Sundström J, Arima H, Jackson R et al. Effects of blood pressure reduction in mild hypertension: a systematic review and meta-analysis. Ann Intern Med 2015; 162(3): 184–191.

5. Neal B, MacMahon S, Chapman N et al. Effects of ACE inhibitors, calcium antagonists, and other blood – pressure – lowering drugs: results of prospectively designed overview of radomised trials. Lancet 2000; 356(9246): 1955–1964.

6. Psaty BM, Smith NL, Siscovick DS et al. Health outcomes associated with antihypertensive therapies used as first-line agents: systematic review and meta-analysis. JAMA 1997; 277(9): 739–745.

7. Lewington S, Clarke R, Qizilbash N et al. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet 2002; 360(9349): 1903–1913.

8. Beckett NS, Peters R, Fletcher AE et al. Treatment of hypertension in patients 80 years of age or older. N Engl J Med 2008; 358(18): 1887–1898.

9. Verdecchia P, Staessen JA, Angeli F et al. Usual versus tight control of systolic blood pressure in non-diabetic patients with hypertension (Cardio.Sis): a open-label randomised trial. Lancet 2009; 374(9689): 525–533. Erratum in Lancet 2009; 374(9693): 880.

10. Cushman WC, Evans GW, Byington RP et al. [ACCORD Study Group]. Effect of intensive blood pressure control in type 2 diabetes mellitus. N Engl J Med 2010; 362(17): 1575–1585.

11. Benavente OR, Coffey CS, Conwit R et al. [SPS3 Study Group]. Blood-pressure targets in patients with recent lacunar stroke: the SPS3 randosed trial. Lancet 2013; 382(9891): 507–515. Erratum in Lancet 2013; 382(9891): 506.

12. Wright JT, Williamson PK, Snyder JK et al. [SPRINT Research Group]. A Randomised Trial of Intensive versus Standard Blood-Pressure Control. N Engl J Med 2015; 373(22): 2103–2116.

13. Perkovic V, Rodgers A. Redefining Blood-Pressure Targets – SPRINT starts the Marathon. N Engl J Med 2015; 373(22): 2175–2178.

14. Drazen JM, Morrissey S, Campion EW et al. A SPRINT to the Finish. N Engl J Med 2015; 373(22): 2174–2175.

15. Cífková R. Změní výsledky studie SPRINT dosavadní doporučení pro léčbu hypertenze? Hypertenze – kardiovaskulární prevence 2016; 5(1): 15–17.

16. Souček M. Studie SPRINT. Kam až snižovat systolický krevní tlak. Hypertenze – kardiovaskulární prevence 2016; 5(1)1: 11–14.

17. Thomopoulos C, Parati G, Zanchetti A. Effects of blood pressure lowering on a outcome incidence in hypertension. 1. Overview, meta-analyses, and meta-regression analyses of randomized trials. J Hypertens 2014; 32(12): 2285–2295.

18. Filipovský J, Widimský J, Ceral J et al. Diagnostické a léčebné postupy u arteriální hypertenze – verze 2012. Hypertenze – kardiovaskulární prevence 2013; 1(3): 1–16.

19. Souček M, Widimský J, Lánská V. Control of hypertension in patients with hypertension, diabetes a impaired fasting glucose by Czech primary care physicians. Kidney Blood Press Res 2006; 29(6): 366–372.

Labels
Diabetology Endocrinology Internal medicine

Article was published in

Internal Medicine

Issue 7-8

2016 Issue 7-8

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