Lipids, blood pressure and kidney update 2014

Banach, Maciej; Aronow, Wilbert S.; Şerban, Corina; Sahabkar, A.; Rysz, Jacek; Voroneanu, Luminița; Covic, Adrian

doi:10.1016/j.phrs.2015.03.009

Cited by 79 publications

(48 citation statements)

References 231 publications

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“…Following these results, other investigators raised the concern that JNC8 will lead to a higher incidence of cardiovascular events and mortality especially in more vulnerable populations. 23 Previous published data from INVEST 24 showed that among hypertensive patients with coronary artery disease (CAD) who are 60 year of age or older, achieving a BP of <150 mmHg as recommended by JCN8 was associated with less benefit than the target of <140 mmHg in terms of all-cause mortality, cardiovascular mortality, stroke, and myocardial infarct. Moreover, results from SPRINT also demonstrated that lowering SBP to 120 mmHg reduces rates of major cardiovascular events and all-cause mortality, suggesting that for SBP the lower goal is better to improve the health in older or high-risk patients.…”

Section: Discussionmentioning

confidence: 99%

Evidence to Maintain the Systolic Blood Pressure Treatment Threshold at 140 mm Hg for Stroke Prevention

et al. 2016

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In 2014, the Eighth Joint National Committee revised the target maximum systolic blood pressure (SBP) from 140 to 150 mmHg in persons aged ≥60 years without diabetes mellitus (DM) or chronic kidney disease (CKD). The evidence from cohort studies supporting this change was sparse, particularly among U.S. minority populations. In the Northern Manhattan Study, 1,750 participants aged ≥60 years and free of stroke, DM, and CKD had SBP measured at baseline and were annually followed for incident stroke. Mean age at baseline was 72±8 years; 63% were women; 48% Hispanic, 25% non-Hispanic white, and 25% non-Hispanic black. Among all participants, 40% were on antihypertensive medications, and 43% had SBP <140 mmHg, 20% 140-149 mmHg, and 37% ≥150 mmHg. Over a median follow-up of 13 years, 182 participants developed stroke. The crude stroke incidence was greater among individuals with SBP ≥150 mmHg (10.8 per 1000 person-years) and SBP 140-149 (12.3) compared to those with SBP<140 (6.2). After adjusting for demographics, vascular risk factors, diastolic BP, and medication use, participants with SBP 140-149 mmHg had an increased risk of stroke (HR, 1.7; 95% CI, 1.2-2.6) compared with those with SBP <140 mmHg. The increased stroke risk was most notable among Hispanics and non-Hispanic blacks. Raising the SBP threshold from 140 to 150 mmHg as a new target for hypertension treatment in older individuals without DM or CKD could have a detrimental effect on stroke risk reduction, especially among minority U.S. populations.

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Section: Discussionmentioning

confidence: 99%

Evidence to Maintain the Systolic Blood Pressure Treatment Threshold at 140 mm Hg for Stroke Prevention

et al. 2016

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“…The magnitude of this pleiotropic action of fibrates in comparison to other conventional and novel lipid-modifying treatments [63][64][65][66][67][68], including selective PPAR modulators [69,70], needs to be determined. More data from longitudinal studies are needed to assess whether the improvement in FMD may reflect a true reduction in the cardiovascular risk and if this positive effects are restricted to some particular categories of patients.…”

Section: Discussionmentioning

confidence: 99%

Fibrate therapy and flow-mediated dilation: A systematic review and meta-analysis of randomized placebo-controlled trials

Sahebkar

Giua

Pedone

et al. 2016

Pharmacological Research

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Flow-mediated dilation (FMD) of the brachial artery reflects endothelium-dependent vasodilator function; since it correlates with coronary endothelial function, its reduction could predict cardiovascular events. Several studies have investigated the potential impact of fibrates therapy on endothelial function, but clinical findings have not been fully consistent. We aimed to conduct a meta-analysis of randomized placebo-controlled trials in order to clarify whether fibrate therapy could improve endothelial function. A systematic search in PubMed-Medline, SCOPUS, Web of Science and Google Scholar databases was performed to identify randomized placebo-controlled trials investigating the effect of fibrates on endothelial function as estimated by FMD. A randomeffects model and generic inverse variance method were used for meta-analysis. Sensitivity analysis, risk of bias evaluation, and publication bias assessment were carried out using standard methods. Random-effects meta-regression was used to evaluate the impact of treatment duration on the estimated effect size. Fifteen trials with a total of 556 subjects met the eligibility criteria. Fibrate 3 therapy significantly improves FMD (weighted mean difference [WMD]: 1.64%, 95% CI: 1.15, 2.13, p < 0.001) and the result was confirmed in both subgroups with treatment durations ≤8 weeks (WMD: 1.35%, 95% CI: 0.85, 1.86, p < 0.001) and >8 weeks (WMD: 2.55%, 95% CI: 1.21, 3.89, p < 0.001). When the analysis was stratified according to the fibrate type, a significant effect was observed with fenofibrate but not with gemfibrozil, though difference between the two subgroups was not significant. Meta-analysis of data from trials where nitrate mediated dilation (NMD) was available did not suggest a significant change in NMD following treatment with fibrates. The results of this meta-analysis suggest that fibrates may exert beneficial effects on endothelial function, even over a short-term treatment course.

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“…The results reveal that the importance of estimated pooled effect size is not biased by any type of study. These findings are important since CoQ10 might be a potential therapeutic target for statin intolerance, however our previous meta-analysis on this subject did not confirm the effect of CoQ10 supplementation (with doses up to 600 mg/day) in reducing statin-induced myalgia [32,33].…”

Section: Discussionmentioning

confidence: 95%

Statin therapy and plasma coenzyme Q10 concentrations—A systematic review and meta-analysis of placebo-controlled trials

Banach

Şerban

Ursoniu

et al. 2015

Pharmacological Research

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Lipids, blood pressure and kidney update 2014

Cited by 79 publications

References 231 publications

Evidence to Maintain the Systolic Blood Pressure Treatment Threshold at 140 mm Hg for Stroke Prevention

Evidence to Maintain the Systolic Blood Pressure Treatment Threshold at 140 mm Hg for Stroke Prevention

Fibrate therapy and flow-mediated dilation: A systematic review and meta-analysis of randomized placebo-controlled trials

Statin therapy and plasma coenzyme Q10 concentrations—A systematic review and meta-analysis of placebo-controlled trials

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