Evidence for and Against ACC/AHA 2017 Guideline for Target Systolic Blood Pressure of &lt; 130 mmHg in Persons with Type 2 Diabetes

Shen, Jenny I.; Nicholas, Susanne B.; Williams, S. V.; Norris, Keith C.

doi:10.1007/s11886-019-1251-4

Cited by 9 publications

(4 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Whereas the SPRINT study did not include diabetic patients, the primary results for the Action to Control Risk in Diabetes (ACCORD) blood pressure trial only reported a reduction in the risk of stroke (HR, 0.59; 95%CI, 0.39-0.89) at systolic BP < 120 mmHg. However, a re-analysis of the ACCORD trial found that participants randomized to less-intense glycemic control (HbA1c 7.0-7.9%) benefited from targeting systolic BP < 120 mmHg vs. 140 mmHg [ 10 , 12 ].…”

Section: Reviewmentioning

confidence: 99%

The Evolution of Hypertension Guidelines Over the Last 20+ Years: A Comprehensive Review

Evbayekha¹,

Okobi²,

Okobi³

et al. 2022

Cureus

View full text Add to dashboard Cite

Hypertension is the most common modifiable risk factor for cardiovascular and cerebrovascular diseases. In the last two decades, the guidelines have evolved tremendously from areas with no recommendations for screening or treatment to targeted recommendations for some at-risk groups. We sought to go through the literature that provided guidelines for the management of hypertension at any point in time over the last 22 years from 2000 to 2022. We searched four databases: PubMed, Embase, Google Scholar, and Cochrane, using specified search terms. The keywords used were "hypertension" and "guidelines." We combined them using the Boolean operators (AND, OR) and searched for articles. A total of 2461 publications were initially identified; 348 publications were excluded after screening for full-text availability. The full-text articles were further filtered based on title and abstract screening. Following this, a total of 1443 articles were excluded. The remaining 670 full-text articles were assessed for eligibility. Of the 670 full-text articles, 480 were excluded based on exclusion criteria, and following the full-text article screening, 190 articles met the final inclusion criteria. Most of these guideline evolutions concerned establishing and adjusting thresholds for the subgroups of the elderly population and patients with diabetic kidney disease, chronic kidney disease, and stroke. Furthermore, the medications of choice are now guided by the stage of disease, presence or absence of comorbidities, and other relevant information, as opposed to ethnicity, which was previously a heavy yardstick for medication choice.

show abstract

Section: Reviewmentioning

confidence: 99%

The Evolution of Hypertension Guidelines Over the Last 20+ Years: A Comprehensive Review

Evbayekha¹,

Okobi²,

Okobi³

et al. 2022

Cureus

View full text Add to dashboard Cite

show abstract

“…Hypertension was defined as blood pressure > 140/90 mmHg or treatments with antihypertensive medication. The diagnosis of diabetes mellitus was based on the 2017 Standards of Medical Care in Diabetes ( 7 ). In coronary computed tomography angiography (CCTA), the degree of coronary stenosis was classified as obstructive (luminal stenosis ≥ 50% of the coronary diameter) or non-obstructive (luminal stenosis < 50%) ( 8 ).…”

Section: Methodsmentioning

confidence: 99%

Construction and validation of a clinical prediction model for asymptomatic obstructive coronary stenosis in patients with carotid stenosis

Qin,

Li,

Luo

et al. 2023

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

BackgroundCoronary artery stenosis occurs frequently in patients with carotid artery stenosis. We developed a clinical predictive model to investigate the clinical risk of asymptomatic obstructive coronary artery stenosis in patients with carotid artery stenosis ≥ 50%.MethodsFrom January 2018 to January 2022, carotid stenosis patients hospitalized at the First Affiliated Hospital of Zhengzhou University's Department of Endovascular Surgery were subjected to a retrospective analysis of their clinical information and imaging results. Excluded criteria were patients with lacking data, symptomatic coronary stenosis, prior coronary artery bypass grafting, and coronary stent implantation. Patients were separated into case and control groups according to whether or not they had obstructive coronary stenosis. Independent predictors were screened using univariate and multivariate logistic regression, and their accuracy was confirmed using least absolute shrinkage and selection operator (LASSO) regression. A Nomogram prediction model was developed using the aforementioned filtered factors. The model's discrimination and specificity were evaluated using the receiver operating characteristic curve (ROC) and Hosmer-Lemeshow goodness-of-fit test. Internal validation employed the Bootstrap procedure. The clinical decision curve analysis (DCA) of the prediction model was developed to assess the clinical applicability of the model.ResultsThe investigation included a total of 227 patients, of whom 132 (58.1%) had coronary artery stenosis. Hypertension, Grade I plaque, HbA1c ≥ 7.0%, MPV ≥ 9.2fl, and Fib ≥ 3.0 g/L were independent predictors, with OR values of (2.506, 0.219, 0.457, 1.876, 2.005), according to multivariate logistic regression. Risk factor screening and validation using lasso regression. The predictors chosen based on the optimal λ value are consistent with the predictors identified by multiple regression. The area under the ROC curve (AUC) of the model based on the above predictors was 0.701 (0.633–0.770), indicating that the model discriminated well. The calibration curve of the model closely matched the actual curve, and P > 0.05 in the Hosmer-Lemeshow goodness-of-fit test indicated the model's accuracy. The results of the DCA curve demonstrate the clinical applicability of the prediction model.ConclusionHypertension, grade I plaque, HbA1c ≥ 7.0%, MPV ≥ 9.2 fl, and Fib ≥ 3.0 g/L are predictors of asymptomatic coronary stenosis in patients with carotid stenosis ≥50%. The diagnostic model is clinically applicable and useful for identifying patients at high risk.

show abstract

“…Hypertension was defined as a systolic blood pressure ≥ 140 mmHg and/or a diastolic blood pressure ≥ 90 mmHg at least on two distinct occasions 27 . Diabetes mellitus was defined as two fasting plasma glucose (FPG) level ≥ 7.0 mmol/L 28 . The following information was collected: age, gender, hypertension, diabetes, total cholesterol (TC), TG, high-density lipoprotein cholesterol (HDL-C), and LDL-C.…”

Section: Methodsmentioning

confidence: 99%

Genetic variation of RNF145 gene and blood lipid levels in Xinjiang population, China

Ming

Wei

Han

et al. 2021

Sci Rep

View full text Add to dashboard Cite

Dyslipidemia is one of the main risk factors for coronary heart disease (CHD). The E3 ubiquitin ligase which is encoded by the ring finger protein 145 (RNF145) gene is very important in the mediation of cholesterol synthesis and effectively treats hypercholesterolemia. Thus, the purpose of the present research is to investigate the connection between the polymorphism of the RNF145 gene and cholesterol levels in the populations in Xinjiang, China. A total of 1396 participants (Male: 628, Female: 768) were included in this study for genetic analysis of RNF145 gene, and we used the modified multiple connection detection response (iMLDR) technology to label two SNPs (rs17056583, rs12188266) of RNF145 genotyping. The relationship between the genotypes and the lipid profiles was analyzed with general linear model analysis after adjusting confounding variables. Through the analysis of the two SNPs in RNF145 gene, we discovered that both rs17056583 and rs12188266 were related to total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) concentrations (All P < 0.001). In addition, the association of rs17056583 and rs12188266 with lipid profiles concentrations is still statistically significant after multivariate adjustment of sex, age, smoking, obesity, drinking, diabetes, hypertension and lipid profiles. Meanwhile, we also found that rs17056583 was associated with high triglycerides concentrations before and after adjustment (All P < 0.001). Our study shows that both rs17056583 and rs12188266 SNPs of RNP145 gene are related to TC and LDL-C concentrations in Xinjiang population.

show abstract

Evidence for and Against ACC/AHA 2017 Guideline for Target Systolic Blood Pressure of < 130 mmHg in Persons with Type 2 Diabetes

Cited by 9 publications

References 43 publications

The Evolution of Hypertension Guidelines Over the Last 20+ Years: A Comprehensive Review

The Evolution of Hypertension Guidelines Over the Last 20+ Years: A Comprehensive Review

Construction and validation of a clinical prediction model for asymptomatic obstructive coronary stenosis in patients with carotid stenosis

Genetic variation of RNF145 gene and blood lipid levels in Xinjiang population, China

Contact Info

Product

Resources

About