A Case for Less Intensive Blood Pressure Control: It Matters to Achieve Target Blood Pressure Early and Sustained Below 140/90mmHg

Mariampillai, Julian E.; Eskås, Per Anders; Heimark, Sondre; Kjeldsen, Sverre E.; Mancia, Giuseppe

doi:10.1016/j.pcad.2016.09.002

Cited by 20 publications

(8 citation statements)

References 29 publications

(19 reference statements)

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“…However, the evidence regarding the benefit of pharmacological anti-hypertensive treatment has been known for a long time (34). There is currently not complete consensus between European and American guidelines regarding treatment target (26,35), but early and sustained blood pressure control is nonetheless important (36).…”

Section: Hypertensionmentioning

confidence: 99%

Exercise systolic blood pressure at moderate workload predicts cardiovascular disease and mortality through 35 years of follow-up in healthy, middle-aged men

et al. 2017

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Section: Hypertensionmentioning

confidence: 99%

Exercise systolic blood pressure at moderate workload predicts cardiovascular disease and mortality through 35 years of follow-up in healthy, middle-aged men

et al. 2017

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“…Findings from a limited number of studies suggest that having BP control at a greater proportion of visits over time is associated with a lower CVD risk . However, prior studies included primarily white participants, those with existing coronary heart disease (CHD), or with multiple CVD risk factors .…”

Section: Introductionmentioning

confidence: 99%

“…Findings from a limited number of studies suggest that having BP control at a greater proportion of visits over time is associated with a lower CVD risk. [11][12][13] However, prior studies included primarily white participants, those with existing coronary heart disease (CHD), or with multiple CVD risk factors. [12][13][14] The purpose of the current study was to determine the association of sustained BP control with CHD, stroke, HF, and mortality in an observational analysis of a demographically and clinically diverse population within a large clinical trial.…”

mentioning

confidence: 99%

Sustained blood pressure control and coronary heart disease, stroke, heart failure, and mortality: An observational analysis of ALLHAT

Bowling

Davis

Luciano

et al. 2019

J of Clinical Hypertension

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Achieving blood pressure (BP) control is associated with lower cardiovascular disease (CVD) risk, but less is known about CVD risk associated with sustained BP control over time. This observational analysis of the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) was restricted to participants with 4 to 7 visits with systolic BP (SBP) measurements during a 22-month period (n=24,309). We categorized participants as having sustained BP control (SBP <140 mm Hg) at 100%, 75% to <100%, 50% to <75%, and <50% of visits during this period. Outcomes included fatal coronary heart disease (CHD)/nonfatal myocardial infarction (MI), stroke, heart failure (HF), a composite CVD outcome (fatal CHD/nonfatal MI, stroke, and HF), and mortality. Hazard ratios (HRs) for the association of category of sustained BP control for each outcome were obtained using proportional hazards models. SBP control was present among 20.0% of participants at 100%, 16.4% at 75% to less than 100%, 27.0% at 50% to less than 75%, and 36.6% less than 50% of visits. Compared to those with SBP control at 100% visits, adjusted HR (95% CI) among those with SBP control at < 50% of visits were 1.16 (0.93–1.44) for fatal CHD/nonfatal MI, 1.71 (1.26–2.32) for stroke, 1.63 (1.30–2.06) for HF, 1.39 (1.20–1.62) for the composite CVD outcome, and 1.14 (0.99–1.44) for mortality. Sustained SBP control may be beneficial for preventing stroke, HF, and CVD outcomes in adults taking antihypertensive medication.

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“…Randomised event-based clinical intervention trials have proven little evidence to support the recommendations of guidelines [1][2][3] that in hypertensive people at high cardiovascular (CV) risk, with or without type 2 diabetes mellitus, blood pressure (BP) should be treated to <130/ 80 mmHg rather than to <140/90 mmHg [4][5][6]. The Hypertension Optimal Treatment (HOT) Study randomised almost 19,000 hypertensive patients from the general population to three different diastolic BP targets, 80, 85 and 90 mmHg while systolic BPs remained above 140 mmHg.…”

Section: Introductionmentioning

confidence: 99%

Cardiovascular outcomes at recommended blood pressure targets in middle-aged and elderly patients with type 2 diabetes mellitus compared to all middle-aged and elderly hypertensive study patients with high cardiovascular risk

et al. 2021

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A Case for Less Intensive Blood Pressure Control: It Matters to Achieve Target Blood Pressure Early and Sustained Below 140/90mmHg

Cited by 20 publications

References 29 publications

Exercise systolic blood pressure at moderate workload predicts cardiovascular disease and mortality through 35 years of follow-up in healthy, middle-aged men

Exercise systolic blood pressure at moderate workload predicts cardiovascular disease and mortality through 35 years of follow-up in healthy, middle-aged men

Sustained blood pressure control and coronary heart disease, stroke, heart failure, and mortality: An observational analysis of ALLHAT

Cardiovascular outcomes at recommended blood pressure targets in middle-aged and elderly patients with type 2 diabetes mellitus compared to all middle-aged and elderly hypertensive study patients with high cardiovascular risk

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