Intensive Blood Pressure Treatment in Adults Aged 60 Years or Older

2017 ◽  
Vol 167 (4) ◽  
pp. 288
Author(s):  
Gulistan Bahat ◽  
Birkan Ilhan ◽  
Asli Tufan ◽  
Mehmet Akif Karan
Keyword(s):  
Blood Pressure ◽  
Pressure Treatment ◽  
Blood Pressure Treatment ◽  
Intensive Blood Pressure

scholarly journals Risk–benefit profile of intensive blood pressure treatment

2018 ◽  
Vol 6 (8) ◽  
pp. 601-602 ◽  
Author(s):  
João Sérgio Neves ◽  
Lia Leitão ◽  
Rita Magriço ◽  
Catarina Viegas Dias ◽  
Miguel Bigotte Vieira
Keyword(s):  
Blood Pressure ◽  
Pressure Treatment ◽  
Blood Pressure Treatment ◽  
Intensive Blood Pressure

scholarly journals Impact of cumulative SBP and serious adverse events on efficacy of intensive blood pressure treatment

2019 ◽  
Vol 37 (5) ◽  
pp. 1058-1069 ◽  
Author(s):  
Oscar L. Rueda-Ochoa ◽  
Lyda Z. Rojas ◽  
Shahzad Ahmad ◽  
Cornelia M. van Duijn ◽  
Mohammad A. Ikram ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Adverse Events ◽  
Pressure Treatment ◽  
Serious Adverse Events ◽  
Blood Pressure Treatment ◽  
Intensive Blood Pressure

Benefits and Harms of Intensive Blood Pressure Treatment in Adults Aged 60 Years or Older

2017 ◽  
Vol 166 (6) ◽  
pp. 419 ◽  
Author(s):  
Jessica Weiss ◽  
Michele Freeman ◽  
Allison Low ◽  
Rochelle Fu ◽  
Amy Kerfoot ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Pressure Treatment ◽  
Blood Pressure Treatment ◽  
Intensive Blood Pressure

P796Intensive blood pressure treatment significantly increases visit-to-visit systolic blood pressure variability. A randomized clinical trial

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
O L Rueda-Ochoa ◽  
L Z Rojas Sanchez ◽  
M A Ikram ◽  
J W Deckers ◽  
O H Franco ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Primary Outcome ◽  
Total Population ◽  
Standard Treatment ◽  
Intensive Treatment ◽  
Pressure Treatment ◽  
Treatment Groups ◽  
Blood Pressure Treatment ◽  
Intensive Blood Pressure

Abstract Background Intensive blood pressure lowering is increasingly gaining attention. Besides higher baseline blood pressure, visit-to-visit variability has showed association with target organ damage and major adverse cardiovascular outcomes in multiple medical reports. Purpose Our aim was to assess the effect of intensive treatment on systolic blood pressure (SBP) visit-to-visit variability in the SPRINT trial population during follow-up. Methods We included 9068 SPRINT participants with 128139 repeated SBP measurements. Participants were randomly assigned to intensive (SBP <120 mmHg) vs standard treatment (SBP between 135–139 mmHg). The primary outcome was a composite outcome of myocardial infarction, other acute coronary syndromes, acute decompensated heart failure, stroke, and cardiovascular mortality. We calculated the coefficient of variation (CV) and standard deviation (SD), taking into account all SBP measurements prior to the SPRINT primary outcome. Comparison of CV between intensive and standard treatment in the total SPRINT population and among different subgroups was made. Results CVs in intensive treatment groups were higher in total population and in all groups under study (See table). While second and third CV quartile showed a larger tendency to increase the risk for the primary SPRINT outcome in the intensive treatment compared to the standard treatment group, fourth CV quartiles were significantly associated with increase in primary SPRINT outcome in both intensive and standard treatment groups. Coefficient of variation in SPRINT trial Group Intensive treatment Standard treatment Total population 9.80 (3.22)* 8.52 (2.96) Females 10.46 (3.29)* 9.18 (3.15) Black person 9.99 (3.38)* 8.82 (3.15) Prevalence CKD 10.14 (3.22)* 9.12 (3.06) Prevalence CVD 10.28 (3.32)* 8.93 (3.23) ≥75 year 10.40 (3.18)* 9.01 (3.07) SAEs 10.30 (3.39)* 9.08 (3.13) (CKD: chronic kidney disease; CVD: cardiovascular disease; SAEs: serious adverse events. *P<0.05). Conclusions Intensive blood pressure treatment significantly increases SBP visit-to-visit variability in total SPRINT population and in all subgroups under study. Additional longitudinal studies with long-term follow-up are warranted to evaluate the impact of increases in SBP visit-to-visit variability due to intensive treatment on risk of major cardiovascular events.

scholarly journals Benefit and harm of intensive blood pressure treatment: Derivation and validation of risk models using data from the SPRINT and ACCORD trials

PLoS Medicine ◽  
2017 ◽  
Vol 14 (10) ◽  
pp. e1002410 ◽  
Author(s):  
Sanjay Basu ◽  
Jeremy B. Sussman ◽  
Joseph Rigdon ◽  
Lauren Steimle ◽  
Brian T. Denton ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Pressure Treatment ◽  
Risk Models ◽  
Blood Pressure Treatment ◽  
Using Data ◽  
Intensive Blood Pressure

Acute Hypertensive Response in Patients With Acute Intracerebral Hemorrhage: A Narrative Review

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000012276
Author(s):  
Maximiliano A. Hawkes ◽  
Alejandro A. Rabinstein
Keyword(s):  
Blood Pressure ◽  
Clinical Trials ◽  
Intracerebral Hemorrhage ◽  
Clinical Outcomes ◽  
Randomized Clinical Trials ◽  
Hematoma Expansion ◽  
Pressure Treatment ◽  
Blood Pressure Treatment ◽  
Acute Intracerebral Hemorrhage ◽  
Intensive Blood Pressure

ObjectiveTo review the role of the acute hypertensive response in patients with intracerebral hemorrhage, current treatment options and areas for further research.MethodsReview of the literature to assess 1) Frequency of acute hypertensive response in intracerebral hemorrhage 2) Consequences of acute hypertensive response in clinical outcomes 3) Acute hypertensive response and secondary brain injury: hematoma expansion and perihematomal edema 4) Vascular autoregulation, safety data side effects of acute antihypertensive treatment, and 5) Randomized clinical trials and meta-analyses.ResultsAn acute hypertensive response is highly frequent in patients with acute intracerebral hemorrhage, and it is associated with poor clinical outcomes. However, it is not clear whether high blood pressure is a cause poor clinical outcome, or it solely represents a marker of severity. Although current guidelines recommend intensive blood pressure treatment (<140 mmHg) in patients with intracerebral hemorrhage, two randomized clinical trials have failed to demonstrate a consistent clinical benefit from this approach, and new data suggest that intensive blood pressure treatment could be beneficial for some patients, but detrimental for others.ConclusionsIntracerebral hemorrhage is a heterogenous disease, thus, a one-fit-all approach for blood pressure treatment may be suboptimal. Further research should concentrate on finding subgroups of patients more likely to benefit from aggressive BP lowering, considering ICH etiology, ultra-early randomization and risk markers of hematoma expansion on brain imaging.

scholarly journals Effects of Intensive Blood Pressure Treatment on Acute Kidney Injury Events in the Systolic Blood Pressure Intervention Trial (SPRINT)

2018 ◽  
Vol 71 (3) ◽  
pp. 352-361 ◽  
Author(s):  
Michael V. Rocco ◽  
Kaycee M. Sink ◽  
Laura C. Lovato ◽  
Dawn F. Wolfgram ◽  
Thomas B. Wiegmann ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Acute Kidney Injury ◽  
Systolic Blood Pressure ◽  
Kidney Injury ◽  
Pressure Treatment ◽  
Intervention Trial ◽  
Blood Pressure Treatment ◽  
Intensive Blood Pressure
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