scholarly journals Blood Pressure Targets and Absolute Cardiovascular Risk

Hypertension ◽  
2015 ◽  
Vol 66 (2) ◽  
pp. 280-285 ◽  
Author(s):  
Ayodele Odutayo ◽  
Kazem Rahimi ◽  
Allan J. Hsiao ◽  
Connor A. Emdin
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Blood Pressure Targets ◽  
Absolute Cardiovascular Risk

scholarly journals Blood Pressure during Blood Collection and the Implication for Absolute Cardiovascular Risk Assessment

Pulse ◽  
2020 ◽  
Vol 8 (1-2) ◽  
pp. 40-46
Author(s):  
Niamh Chapman ◽  
Dean S Picone ◽  
Rachel E. Climie ◽  
Martin G. Schultz ◽  
Mark R. Nelson ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Risk Assessment ◽  
Cardiovascular Risk ◽  
Blood Collection ◽  
Cardiovascular Risk Assessment ◽  
Absolute Cardiovascular Risk

Essential hypertension—definition, epidemiology, and pathophysiology

2010 ◽  
pp. 3023-3039
Author(s):  
Bryan Williams
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Cardiovascular Risk ◽  
High Blood Pressure ◽  
Clinical Benefit ◽  
Lower Blood Pressure ◽  
Significant Clinical Benefit ◽  
Lower Blood ◽  
Absolute Cardiovascular Risk

‘Essential hypertension’ is high blood pressure for which there is no clearly defined aetiology. From a practical perspective, it is best defined as that level of blood pressure at which treatment to lower blood pressure results in significant clinical benefit—a level which will vary from patient to patient depending on their absolute cardiovascular risk....

scholarly journals Cardiovascular Risk and Atherosclerosis Progression in Hypertensive Persons Treated to Blood Pressure Targets

Hypertension ◽  
2019 ◽  
Vol 74 (6) ◽  
pp. 1436-1447 ◽  
Author(s):  
Janine Gronewold ◽  
Rene Kropp ◽  
Nils Lehmann ◽  
Andreas Stang ◽  
Amir A. Mahabadi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Arterial Hypertension ◽  
Treatment Efficacy ◽  
Cardiovascular Events ◽  
Antihypertensive Treatment ◽  
Coronary Event ◽  
Blood Pressure Targets ◽  
Atherosclerosis Progression

Arterial hypertension promotes atherosclerosis and cardiovascular events. We evaluated how cardiovascular risk and atherosclerosis progression are associated with blood pressure, antihypertensive treatment, and treatment efficacy. In 3555 participants of the population-based Heinz Nixdorf Recall study without previous cardiovascular disease (mean±SD; age, 58.9±7.6 years, 46.9% men), we analyzed associations of baseline antihypertensive treatment efficacy (normotension without antihypertensives, normotension with antihypertensives, hypertension without antihypertensives, hypertension with antihypertensives, based on 140/90 mmHg cutoffs) with incident coronary artery calcification (CAC) and CAC progression during 5-year-follow-up and with incident cardiovascular events during 13.5-year-follow-up. We further evaluated associations of incident arterial hypertension and efficacy of new antihypertensive treatment at the 5-year-follow-up with subsequent cardiovascular events. At baseline, 1706 participants had normotension without antihypertensives, 553 normotension with antihypertensives, 786 hypertension without antihypertensives, and 510 hypertension with antihypertensives. Six hundred forty-seven participants experienced rapid CAC progression. One hundred seven, 132, and 249 had incident stroke, coronary event, and cardiovascular event, respectively. Compared with normotensives without antihypertensives, normotensives with antihypertensives had an elevated stroke (hazard ratio, 2.33 [95% CI, 1.19–4.55]), coronary (2.04 [95% CI, 1.20–3.45]), and cardiovascular (2.23 [95% CI, 1.48–3.36]) risk, and increased baseline CAC, but not increased CAC progression. Participants without hypertension at baseline, who were newly hypertensive but achieved normotension with antihypertensives at the 5-year-follow-up, again exhibited elevated stroke (4.80 [95% CI, 1.38–16.70]) and cardiovascular (2.99 [95% CI, 1.25–7.16]) risk, whereas coronary risk was less elevated (2.24 [95% CI, 0.70–7.18]). Normotensives with antihypertensives have an elevated cardiovascular risk. They are characterized by elevated baseline CAC but show no signs of increased CAC progression.

scholarly journals Low on-treatment diastolic blood pressure and cardiovascular outcome: A post-hoc analysis using NHLBI SPRINT Research Materials

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Piotr Sobieraj ◽  
Jacek Lewandowski ◽  
Maciej Siński ◽  
Zbigniew Gaciong
Keyword(s):  
Myocardial Infarction ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Diastolic Blood Pressure ◽  
Acute Decompensated Heart Failure ◽  
Blood Pressure Reduction ◽  
Clinical Effects ◽  
Pressure Reduction ◽  
Blood Pressure Targets ◽  
Coronary Syndrome

Abstract Recent studies including the SPRINT trial have shown beneficial effects of intensive systolic blood pressure reduction over the standard approach. The awareness of the J-curve for diastolic blood pressure (DBP) causes some uncertainty regarding the net clinical effects of blood pressure reduction. The current analysis was performed to investigate effects of low on-treatment DBP on cardiovascular risk in the SPRINT population. The primary composite outcome was the occurrence of myocardial infarction, acute coronary syndrome not resulting in myocardial infarction, stroke, acute decompensated heart failure or death from cardiovascular causes. The prevalence of primary outcomes was significantly higher in subjects within low DBP in both standard (44–67 mmHg [10.8%] vs 67–73 mmHg [6.7%] vs 73–78 mmHg [5.1%] vs 78–83 mmHg [4.4%] vs 83–113 mmHg [4.3%], p < 0.001) and intensive treatment (38–61 mmHg [6.7%] vs 61–66 mmHg [4.1%] vs 66–70 mmHg [4.5%] vs 70–74 mmHg [2.7%] vs 74–113 mmHg [3.4%], p < 0.001) arms. After adjusting for covariates, low DBP showed no significant effects on cardiovascular risk. Therefore, while reaching blood pressure targets, low DBP should not be a matter of concern.

Time in blood pressure range for different blood pressure targets and risk of cardiovascular disease: an analysis of a 7-year follow-up registry

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
K Sideris ◽  
A Kasiakogias ◽  
D Konstantinidis ◽  
P Papakonstantinou ◽  
F Tatakis ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Composite Endpoint ◽  
Hypertensive Patients ◽  
Blood Pressure Targets ◽  
History Of ◽  
Optimal Target ◽  
Artery Disease ◽  
Blood Pressure Range

Abstract Objective Recent guideline recommendations have revisited the optimal target blood pressure (BP) for hypertensive patients. The Time in BP Range (TBPR) is an alternative metric for evaluation of long-term achieved BP. We investigated the association of TBPR for different levels of BP control with cardiovascular outcome among treated hypertensives. Design and method This is a retrospective analysis of 1202 treated hypertensive patients (age 59±11 years) without a history of cardiovascular disease followed for a mean period of 7±3 years. We calculated the TBPR [(No of Visits in BP range/ Total No of Visits) x 100%] for office systolic BP targets of 130–139mmHg, 120–129mmHg and &lt;120mmHg and examined the associated cardiovascular risk. The outcome studied was the composite of stroke and coronary artery disease. Time spent in systolic BP≥140mmHg served as the reference. Results In the entire population, mean TBPR for systolic BP 130–139mmHg, 120–129mmH, and &lt;120mmHg were 26%, 19% and 11% respectively. A TBPR of ≥50% for systolic BP 130–139mmHg, 120–129mmHg and &lt;120mmHg was observed in 332 (28%), 226 (19%) and 107 (9%) patients respectively. The composite endpoint occurred in 54 patients (4.5%). Patients with a TBPR for 120–140mmHg of ≥50% presented with a HR: 0.6 (95% CI: 0.34–1.06) for cardiovascular events. The TBPR of ≥50% for systolic BP 130–139mmHg, 120–129mmHg and &lt;120mmHg was associated with HR of 0.48 (95% CI: 0.23–1.01, p=0.05), 0.64 (95% CI: 0.29–1.39, p=0.26) and 0.72 (95% CI: 0.26–2.05) respectively. This pattern was sustained but further attenuated after controlling for standard risk factors. In comparison, a mean BP across visits of 130–139mmHg, 120–129mmHg and &lt;120mmHg was associated with a HR of 0.54 (5% CI: 0.28–1.03), 0.61 (95% CI: 0.29–1.26) and 0.80 (95% CI: 0.24–2.65). Conclusions Among treated hypertensives, a time in BP of 130–140mmHg of more than 50% is associated with the greatest reduction in cardiovascular risk. The TBPR is a potentially useful measure of BP control for evaluation of risk reduction in hypertensive patients. Funding Acknowledgement Type of funding source: None

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