Which Target Blood Pressure in Year 2018? Evidence from Recent Clinical Trials

Forskningsoutput: TidskriftsbidragÖversiktsartikel

Abstract

The Systolic Blood Pressure Intervention Trial (SPRINT) suggested a favourable effect of lowering blood pressure to < 120/80 mmHg in high-risk hypertensive patients; however, new American guidelines in 2017 have not followed SPRINT but lowered its recommended treatment target to < 130/80 mmHg. We aimed to review the latest research from large randomised controlled trials and observational analyses in order to investigate the evidence for new treatment targets. We assessed recent data from the Action to Control Cardiovascular Risk in Diabetes Blood Pressure (ACCORD) study, the International Verapamil-Trandolapril Study (INVEST), the Telmisartan, Ramipril or Both in Patients at High Risk for Vascular Events trial (ONTARGET)/the Telmisartan Randomised AssessmenNt Study in aCE iNtolerant participants with cardiovascular Disease (TRANSCEND) study and The Losartan Intervention For Endpoint Reduction in Hypertension (LIFE) study. These studies confirm a positive effect on cardiovascular protection with blood pressure lowering treatment to between 120–140 mmHg in patients with and without diabetes, but no additional effect of lowering blood pressure to < 120 mmHg; possibly too aggressive treatment may increase both cardiovascular morbidity and mortality. Thus, a target blood pressure < 130/80 mmHg appears appropriate in most high-risk hypertensive patients. Additionally, early and sustained BP control below this target is required for optimal cardiovascular protection.

Detaljer

Författare
  • Sondre Heimark
  • Julian E. Mariampillai
  • Krzysztof Narkiewicz
  • Peter M. Nilsson
  • Sverre E. Kjeldsen
Enheter & grupper
Externa organisationer
  • Diakonhjemmet Hospital
  • Oslo university hospital
  • Medical University of Gdansk
  • Skåne University Hospital
  • University of Oslo
Forskningsområden

Ämnesklassifikation (UKÄ) – OBLIGATORISK

  • Kardiologi

Nyckelord

Originalspråkengelska
Sidor (från-till)151-158
Antal sidor8
TidskriftHigh Blood Pressure and Cardiovascular Prevention
Volym25
Utgåva nummer2
StatusPublished - 2018 jun 1
PublikationskategoriForskning
Peer review utfördJa