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https://www.readbyqxmd.com/read/29337449/-blood-pressure-management-what-s-new-in-2017
#1
Michel Burnier, Grégoire Wuerzner
In the last 2 years, the attention of hypertension specialists has been focused on the results of the SPRINT trial and its post-hoc analyses and its possible implications for the management of hypertensive patients. While waiting for new European hypertension guidelines due in 2018, the year 2017 can be considered as a year of transition. Yet, several interesting clinical studies have been published which may affect the future management of hypertension. Thus we shall discuss new data on the benefits of eating more fruits and vegetables on cardiovascular mortality, the « quadpill » concept, the impact of various non-steroidal anti-inflammatory drugs on blood pressure and the most recent data on renal denervation...
January 10, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29273586/incremental-effects-of-antihypertensive-drugs-instrumental-variable-analysis
#2
Adam A Markovitz, Jacob A Mack, Brahmajee K Nallamothu, John Z Ayanian, Andrew M Ryan
OBJECTIVES: To assess the incremental effects of adding extra antihypertensive drugs from a new class to a patient's regimen. DESIGN: Instrumental variable analysis of data from SPRINT (Systolic Blood Pressure Intervention Trial). To account for confounding by indication-when treatments seem less effective if they are administered to sicker patients-randomization status was used as the instrumental variable. Patients' randomization status was either intensive (systolic blood pressure target <120 mm Hg) or standard (systolic blood pressure target <140 mm Hg) treatment...
December 22, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29218880/causal-inference-on-electronic-health-records-to-assess-blood-pressure-treatment-targets-an-application-of-the-parametric-g-formula
#3
Kipp W Johnson, Benjamin S Glicksberg, Rachel A Hodos, Khader Shameer, Joel T Dudley
Hypertension is a major risk factor for ischemic cardiovascular disease and cerebrovascular disease, which are respectively the primary and secondary most common causes of morbidity and mortality across the globe. To alleviate the risks of hypertension, there are a number of effective antihypertensive drugs available. However, the optimal treatment blood pressure goal for antihypertensive therapy remains an area of controversy. The results of the recent Systolic Blood Pressure Intervention Trial (SPRINT) trial, which found benefits for intensive lowering of systolic blood pressure, have been debated for several reasons...
2018: Pacific Symposium on Biocomputing
https://www.readbyqxmd.com/read/29212825/intensive-blood-pressure-lowering-in-patients-with-and-patients-without-type-2-diabetes-a-pooled-analysis-from-two-randomized-trials
#4
Tom F Brouwer, Jim T Vehmeijer, Deborah N Kalkman, Wouter R Berger, Bert-Jan H van den Born, Ron J Peters, Reinoud E Knops
OBJECTIVE: The Action to Control Cardiovascular Risk in Diabetes Blood Pressure (ACCORD-BP) study did not find a significant beneficial effect of intensive systolic blood pressure (SBP) lowering on cardiovascular events in hypertensive patients with type 2 diabetes mellitus (T2DM), while the Systolic Blood Pressure Intervention Trial (SPRINT) did find a significant beneficial effect in patients without T2DM. The objective of this analysis was to assess the effect of both T2DM and baseline cardiovascular disease (CVD) risk on the treatment effect of intensive blood pressure lowering...
December 6, 2017: Diabetes Care
https://www.readbyqxmd.com/read/29203043/-blood-pressure-target-in-2017
#5
A Yannoutsos, A Bura-Rivière, P Priollet, J Blacher
OBJECTIVE: The issue of how far blood pressure (BP) should be lowered under antihypertensive treatment is still an important matter of scientific debate. The aim of the present review is to consider the clinical relevance of individualized BP goal under treatment in hypertensive patients according to their age, comorbidities or established cardio-vascular (CV) disease. DATA FROM THE LITERATURE: The French and European recommendations propose a systolic BP target between 130 and 139mmHg (<150mmHg after 80 years) and diastolic BP target <90mmHg in hypertensive patients whatever their level of risk...
December 2017: Journal de Médecine Vasculaire
https://www.readbyqxmd.com/read/29176391/the-relationship-of-all-cause-mortality-to-average-on-treatment-systolic-blood-pressure-is-significantly-related-to-baseline-systolic-blood-pressure-implications-for-interpretation-of-the-systolic-blood-pressure-intervention-trial-study
#6
Peter M Okin, Sverre E Kjeldsen, Richard B Devereux
BACKGROUND: The SPRINT study demonstrated that targeting systolic blood pressure (SBP) less than 120 mmHg was associated with lower cardiovascular event and mortality rates. In the LIFE study, however, a lower achieved SBP was associated with increased mortality. Mean baseline SBP in SPRINT was 140 mmHg and a third of the population had a baseline SBP 132 mmHg or less, raising the question of whether the lower baseline SBP in SPRINT could in part account for these differences. METHODS: All-cause mortality during 4...
November 15, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/29133606/effects-of-bariatric-surgery-in-obese-patients-with-hypertension-the-gateway-randomized-trial-gastric-bypass-to-treat-obese-patients-with-steady-hypertension
#7
Carlos Aurelio Schiavon, Angela Cristine Bersch-Ferreira, Eliana Vieira Santucci, Juliana Dantas Oliveira, Camila Ragne Torreglosa, Priscila Torres Bueno, Julia Caldas Frayha, Renato Nakagawa Santos, Lucas Petri Damian, Patricia Malvina Noujaim, Helio Halpern, Frederico L J Monteiro, Ricardo Vitor Cohen, Carlos H Uchoa, Marcio Gonçalves de Souza, Celso Amodeo, Luiz Bortolotto, Dimas Ikeoka, Luciano F Drager, Alexandre Biasi Cavalcanti, Otavio Berwanger
BACKGROUND : Recent research efforts on bariatric surgery have focused on metabolic and diabetes mellitus resolution. Randomized trials designed to assess the impact of bariatric surgery in patients with obesity and hypertension are needed. METHODS : In this randomized, single-center, nonblinded trial, we included patients with hypertension (using ≥2 medications at maximum doses or >2 at moderate doses) and a body mass index between 30.0 and 39.9 kg/m2 Patients were randomized to Roux-en-Y gastric bypass plus medical therapy or medical therapy alone...
November 13, 2017: Circulation
https://www.readbyqxmd.com/read/29117465/more-sprint-controversy
#8
Franz H Messerli, Sripal Bangalore, Stefano F Rimoldi
Frohlich and Zanchetti, at that time editors-in-chief of Hypertension and Journal of Hypertension, wrote the above words 20 years ago, in midst of the so-called calcium blocker controversy in a dual publication [3]. The authors continued in stating "however, controversy should be based on sound scientific evidence". One may ask whether this indeed is not a contradiction in terms as how can sound scientific evidence possibly give rise to controversy? The answer to this question is quite simple: science may be perfectly sound but interpretation thereof very often is anything but...
November 8, 2017: Journal of Internal Medicine
https://www.readbyqxmd.com/read/29051347/bp-measurement-in-clinical-practice-time-to-sprint-to-guideline-recommended-protocols
#9
Paul E Drawz, Joachim H Ix
Hypertension is the leading chronic disease risk factor in the world and is especially important in patients with CKD, nearly 90% of whom have hypertension. Recently, in the Systolic BP Intervention Trial (SPRINT), intensive lowering of clinic systolic BP to a target <120 mm Hg, compared with a standard BP target of <140 mm Hg, reduced risk for cardiovascular disease and all-cause mortality. However, because BP was measured unobserved using an automated device, some investigators have questioned the ability to translate SPRINT results into routine clinical practice, in which measurement of BP is typically less standardized...
October 19, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/29044764/estimated-glomerular-filtration-rate-and-the-risk-benefit-profile-of-intensive-blood-pressure-control-among-non-diabetic-patients-a-post-hoc-analysis-of-a-randomized-clinical-trial
#10
Yoshitsugu Obi, Kamyar Kalantar-Zadeh, Ayumi Shintani, Csaba P Kovesdy, Takayuki Hamano
BACKGROUND: The Systolic Blood Pressure Intervention Trial (SPRINT; ClinicalTrials. gov, NCT01206062) reported reduced cardiovascular events by intensive blood pressure (BP) control among hypertensive patients without diabetes. However, the risk-benefit profile of intensive BP control may differ across estimated glomerular filtration rate (eGFR) levels. METHODS: This is a post-hoc analysis of the SPRINT. Non-diabetic hypertensive adults (n=9,361) with eGFR >20 mL/min/1...
October 16, 2017: Journal of Internal Medicine
https://www.readbyqxmd.com/read/28985268/clinical-outcomes-by-race-and-ethnicity-in-the-systolic-blood-pressure-intervention-trial-sprint-a-randomized-clinical-trial
#11
Carolyn H Still, Carlos J Rodriguez, Jackson T Wright, Timothy E Craven, Adam P Bress, Glenn M Chertow, Paul K Whelton, Jeffrey C Whittle, Barry I Freedman, Karen C Johnson, Capri G Foy, Jiang He, John B Kostis, James P Lash, Carolyn F Pedley, Roberto Pisoni, James R Powell, Barry M Wall
BACKGROUND: The Systolic Blood Pressure Intervention Trial (SPRINT) showed that targeting a systolic blood pressure (SBP) of ≤ 120 mm Hg (intensive treatment) reduced cardiovascular disease (CVD) events compared to SBP of ≤ 140 mm Hg (standard treatment); however, it is unclear if this effect is similar in all racial/ethnic groups. METHODS: We analyzed SPRINT data within non-Hispanic White (NHW), non-Hispanic Black (NHB), and Hispanic subgroups to address this question...
August 23, 2017: American Journal of Hypertension
https://www.readbyqxmd.com/read/28938505/-treatment-targets-in-hypertension
#12
Rainer Düsing
The optimal target blood pressure (BP) in the treatment of hypertensive patients remains controversial. Recently, the systolic blood pressure trial (SPRINT) has proposed that a target systolic blood pressure of < 120 mmHg provides prognostic benefit in elderly hypertensive patients at high cardiovascular risk. The results of SPRINT contrast with several other intervention trials which have investigated the effect of intense BP lowering (Secondary Prevention of Small Subcortical Strokes [SPS3], Action to Control Cardiovascular Risk in Diabetes [ACCORD], Heart Outcomes Prevention Evaluation [HOPE]-3)...
September 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28893522/systolic-blood-pressure-target-in-systemic-arterial-hypertension-is-lower-ever-better-results-from-a-community-based-caucasian-cohort
#13
Concetta Di Nora, Giovanni Cioffi, Annamaria Iorio, Luigi Rivetti, Stefano Poli, Elena Zambon, Giulia Barbati, Gianfranco Sinagra, Andrea Di Lenarda
BACKGROUND: Extensive evidence exists about the prognostic role of systolic blood pressure (SBP) reduction ≤140mmHg. Recently, the SPRINT trial successfully tested the strategy of lowering SBP<120mmHg in patients with arterial hypertension (AH). AIM: To assess whether the SPRINT results are reproducible in a real world community population. METHODS: Cross-sectional, population-based study analyzing data of 24,537 Caucasian people with AH from the Trieste Observatory of CV disease, 2010 to 2015...
September 8, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28887862/systolic-blood-pressure-targets-diastolic-j-curve-and-cuff-artefact-in-blood-pressure-measurement-a-note-of-caution
#14
EDITORIAL
J D Spence
No abstract text is available yet for this article.
November 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28834483/effect-of-intensive-blood-pressure-treatment-on-patient-reported-outcomes
#15
RANDOMIZED CONTROLLED TRIAL
Dan R Berlowitz, Capri G Foy, Lewis E Kazis, Linda P Bolin, Molly B Conroy, Peter Fitzpatrick, Tanya R Gure, Paul L Kimmel, Kent Kirchner, Donald E Morisky, Jill Newman, Christine Olney, Suzanne Oparil, Nicholas M Pajewski, James Powell, Thomas Ramsey, Debra L Simmons, Joni Snyder, Mark A Supiano, Daniel E Weiner, Jeff Whittle
BACKGROUND: The previously published results of the Systolic Blood Pressure Intervention Trial showed that among participants with hypertension and an increased cardiovascular risk, but without diabetes, the rates of cardiovascular events were lower among those who were assigned to a target systolic blood pressure of less than 120 mm Hg (intensive treatment) than among those who were assigned to a target of less than 140 mm Hg (standard treatment). Whether such intensive treatment affected patient-reported outcomes was uncertain; those results from the trial are reported here...
August 24, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28834469/cost-effectiveness-of-intensive-versus-standard-blood-pressure-control
#16
Adam P Bress, Brandon K Bellows, Jordan B King, Rachel Hess, Srinivasan Beddhu, Zugui Zhang, Dan R Berlowitz, Molly B Conroy, Larry Fine, Suzanne Oparil, Donald E Morisky, Lewis E Kazis, Natalia Ruiz-Negrón, Jamie Powell, Leonardo Tamariz, Jeff Whittle, Jackson T Wright, Mark A Supiano, Alfred K Cheung, William S Weintraub, Andrew E Moran
BACKGROUND: In the Systolic Blood Pressure Intervention Trial (SPRINT), adults at high risk for cardiovascular disease who received intensive systolic blood-pressure control (target, <120 mm Hg) had significantly lower rates of death and cardiovascular disease events than did those who received standard control (target, <140 mm Hg). On the basis of these data, we wanted to determine the lifetime health benefits and health care costs associated with intensive control versus standard control...
August 24, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28828478/association-of-jnc-8-and-sprint-systolic-blood-pressure-levels-with-cognitive-function-and-related-racial-disparity
#17
Ihab Hajjar, Kristine J Rosenberger, Ambar Kulshreshtha, Hilsa N Ayonayon, Kristine Yaffe, Felicia C Goldstein
Importance: The Eighth Joint National Committee (JNC-8) recommended treating systolic blood pressure (SBP) to a target below 150 mm Hg in older adults, whereas data from the Systolic Blood Pressure Intervention Trial (SPRINT) suggested that a SBP level of lower than 120 mm Hg decreases cardiovascular event rates. Target SBP guidelines have not addressed the potential that black patients may have greater morbidity and mortality from hypertension, especially with regard to cognitive outcomes...
October 1, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28760878/correction-to-effect-of-intensive-blood-pressure-lowering-on-left-ventricular-hypertrophy-in-patients-with-hypertension-sprint-systolic-blood-pressure-intervention-trial
#18
https://www.readbyqxmd.com/read/28758155/apol1-renal-risk-variants-do-not-associate-with-incident-cardiovascular-disease-or-mortality-in-the-systolic-blood-pressure-intervention-trial
#19
Barry I Freedman, Michael V Rocco, Jeffrey T Bates, Michel Chonchol, Amret T Hawfield, James P Lash, Vasilios Papademetriou, John R Sedor, Karen Servilla, Paul L Kimmel, Barry M Wall, Nicholas M Pajewski
INTRODUCTION: Relationships between apolipoprotein L1 gene (APOL1) renal-risk variants (RRVs) and cardiovascular disease (CVD) remain controversial. To clarify associations between APOL1 and CVD, 2,568 African American Systolic Blood Pressure Intervention Trial (SPRINT) participants were assessed for the incidence of CVD events (primary composite including non-fatal myocardial infarction, acute coronary syndrome not resulting in myocardial infarction, nonfatal stroke, non-fatal acute decompensated heart failure, and CVD death), renal outcomes, and all-cause mortality...
July 2017: KI Reports
https://www.readbyqxmd.com/read/28755159/managing-hypertension-in-the-elderly-what-is-different-what-is-the-same
#20
REVIEW
Wilbert S Aronow
PURPOSE OF REVIEW: The goal is to discuss management of hypertension in the elderly. RECENT FINDINGS: At 3.14-year follow-up of 2636 persons ≥75 years in the Systolic Blood Pressure Intervention Trial (SPRINT), compared with a systolic blood pressure (SBP) goal of <140 mmHg, a SBP goal of <120 mmHg reduced the primary endpoint of myocardial infarction, other acute coronary syndrome, stroke, heart failure, or cardiovascular death by 34% (p = 0.001), all-cause mortality by 33% (p = 0...
August 2017: Current Hypertension Reports
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