Impact of Cardiovascular Risk on the Relative Benefit and Harm of Intensive Treatment of Hypertension

Phillips, Robert A.; Xu, Jiaqiong; Peterson, Leif E.; Arnold, Ryan M.; Diamond, Joseph A.; Schussheim, Adam E.

doi:10.1016/j.jacc.2018.01.074

Cited by 69 publications

(32 citation statements)

References 19 publications

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“…Our review has implications for clinical practice. Clinicians should assess baseline cardiovascular risk, recommend behavioural and pharmacological treatments aiming at blood pressure normalization without hypotension or orthostatic hypotension (91). They should engage patients in life style optimization, blood pressure self-monitoring, and monitoring of drug adverse effects (92).…”

Section: Discussionmentioning

confidence: 99%

Blood pressure targets for hypertension in patients with type 2 diabetes

Aronow

Shamliyan

2018

Ann. Transl. Med

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Section: Discussionmentioning

confidence: 99%

Blood pressure targets for hypertension in patients with type 2 diabetes

Aronow

Shamliyan

2018

Ann. Transl. Med

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“…Следует отметить, что, в соответствии с недавно опубликованными данными [4], наибольшие преимущества 3 от снижения АД до более низких целевых уровней будут иметь больные с наиболее высоким риском развития осложнений ССЗ, обусловленных атеросклерозом, т. е. прежде всего больные пожилого и старческого возраста. Результаты вторичного анализа данных участников исследования SPRINT [4] позволяют предположить, что только у больных с АГ и 10-летним риском развития осложнений ССЗ, достигающим 18,2% или более, будут отмечаться преимущества ИРТ, в то время как у больных с АГ и риском развития таких заболеваний менее 18,2% приемлемым в большинстве случаев будет стандартный режим антигипертензивной терапии (СРТ).…”

Section: изменение рекомендаций по тактике лечения больных с артериалunclassified

New targets and old therapies for arterial hypertension

et al. 2019

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The article discusses approaches to the choice of antihypertensive drugs, which may be based on the adoption and implementation of new clinical guidelines for the management of patients with arterial hypertension. This paper provides data on the efficacy and safety of candesartan, an antihypertensive drug, which advantages were identified during a large number of randomized clinical trials. It discusses the recently published data on the effectiveness of more intensive regimens of antihypertensive therapy to reduce the risk of moderate cognitive impairment in patients with arterial hypertension. In this regard, the authors provide data of the previously completed studies, which showed the effect of candesartan on the rate of cognitive decline in patients with arterial hypertension in the elderly and senile age. The features of the pharmacological characteristics of candesaratan that can remotely explain its clinical efficacy are considered. The data of experimental studies of candesartan in animals, which contribute to the concept of the possible effects of candesartan, are presented.

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“…Об этом, в частности, свидетельствуют результаты недавно опубликованного вторичного анализа данных об участниках исследования SPRINT. Результаты такого анализа позволяют предположить, что только у больных с АГ и 10-летним расчетным риском развития осложнений ССЗ, достигающим 18,2% или более, будут отмечаться преимущества интенсивного режима антигипертензивной терапии, в то время как у больных с АГ и риском развития таких заболеваний менее 18,2% в большинстве случаев будет приемлемым стандартный режим антигипертензивной терапии [9]. Таким образом, можно предполагать, что на самом деле расчетный риск, с которого снижение АД до более низких цифр будет иметь преимущества, составляет около 20%, а не 10%, как предполагают авторы американских рекомендаций.…”

Section: Treatment Of Patients With Hypertension and Dyslipidemiaunclassified

Evidence, Guidelines and Treatment Algorithms for Patients with Arterial Hypertension and Dyslipidemia: the Need for Compromise and Optimization of Tactics in Practical Healthcare

Drapkina

Ezhov

Gilyarevsky

et al. 2019

Racionalʹnaâ farmakoterapiâ v kardiologii

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The scientific basis of the selection algorithms for the management of patients with hypertension and hypercholesterolemia is presented in article. The advantages and limitations of current recommendations on the management of patients with hypercholesterolemia, which were presented by American and European experts, are discussed. Data on the narrow-mindedness of use of risk assessment scales for the development of cardiovascular complications for primary prevention in a wide population are presented. The question of the ratio of proven facts and expert opinions in clinical recommendations, as well as the validity of a flexible approach to the choice of tactics for a specific patient, considering the most acceptable approaches presented in different clinical recommendations, is being considered. The validity of recommendations for achieving lower concentrations of lowdensity lipoprotein cholesterol in patients with high and very high cardiovascular risk is discussed. The difficult problem of choosing target blood pressure levels in patients with hypertension and with some characteristics or concomitant diseases and/or risk factors is discussed. The evidence base of modern drugs for preventing the development of cardiovascular complications and/or treating patients with such complications is discussed, including new data on the benefits of longer treatment with atorvastatin for the primary prevention of cardiovascular complications in patients with hypertension are discussed. Data on the problems of the choice of drugs used for the primary or secondary prevention of cardiovascular complications in patients with hypertension and hypercholesterolemia are presented.

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Impact of Cardiovascular Risk on the Relative Benefit and Harm of Intensive Treatment of Hypertension

Cited by 69 publications

References 19 publications

Blood pressure targets for hypertension in patients with type 2 diabetes

Blood pressure targets for hypertension in patients with type 2 diabetes

New targets and old therapies for arterial hypertension

Evidence, Guidelines and Treatment Algorithms for Patients with Arterial Hypertension and Dyslipidemia: the Need for Compromise and Optimization of Tactics in Practical Healthcare

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