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Outcome beyond blood pressure control?
| Content Provider | Semantic Scholar |
|---|---|
| Author | Staessen, Jan A. Wang, Ji Guang |
| Copyright Year | 2003 |
| Abstract | The last two decades witnessed the publication of a large number of clinical outcome trials of blood pressure lowering agents in hypertensive patients or normotensive subjects with a high cardiovascular risk profile. Placebo-controlled trials of antihypertensive drug treatment in middle-aged or older hypertensive patients predominantly with diastolic hypertension proved that a 5–6 mmHg decline in diastolic pressure maintained over 5 years diminished the incidence of stroke by nearly 40% and that of coronary endpoints by 15%. Similarly, in older patients with isolated systolic hypertension, pharmacological intervention during 4 years reduced systolic pressure on average by 10 mmHg and decreased cardiovascular mortality by 18%, all cardiovascular complications by 26%, stroke by 30%, and coronary events by 23%. Until recently, the consensual interpretation of the evidence produced by the outcome trials in hypertensive patients was that blood pressure is a risk factor amenable to intervention, lower levels leading to fewer complications. However, the HOPE trial gave rise to the hypothesis that angiotensin-converting enzyme inhibitors (ACEIs) might reduce cardiovascular complications beyond blood pressure control. Subsequently published trials of angiotensin II receptor blockers (ARBs) in hypertensive patients with renal failure or left ventricular hypertrophy turned this concept into a major argument for drug marketing. The objectives of this editorial are to highlight the contribution of blood pressure lowering in the prevention of cardiovascular complications and to propose from a scientific perspective new research priorities for clinical trials in hypertension. |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | https://oup.silverchair-cdn.com/oup/backfile/Content_public/Journal/eurheartj/24/6/10.1016_S0195-668X(02)00797-2/3/0.2007972.504.pdf?Expires=1498764719&Key-Pair-Id=APKAIUCZBIA4LVPAVW3Q&Signature=eEVS-zhgxTgoxyhNLU9rONGbX43rzP3eZHPm6CKRTcdgsIGP1zEctNEJ5utM6reyEh6VQNcRAQvI5sbbVka6iafO6fd7rmVp0S-ANDzWml4mFUZyppRkrxhRl6FATDFUcfe23nhB5GAracwbLfg8w~WpVvpyz1GIOrUcXp18GWafnkNTtWqkbw7qA0aRXgp8F~UrGKATduuNv0de90z7WO2NILkgnnVCZ3h7ovGoSg7uAx8Lfo6D1oCgcg-~6mwxWoNvocoVPJRijNKftwCHK~lknsC04ziu2Ti9aRJhb7v7nHynfWNU4w7z7ojK9cArEjFWtG77rkv0bhqJChk6LQ__ |
| PubMed reference number | 12643883v1 |
| Volume Number | 24 |
| Issue Number | 6 |
| Journal | European heart journal |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Angiotensin II Angiotensin-Converting Enzyme Inhibitors Angiotensins Antihypertensive Agents Cardiovascular Diseases Cerebrovascular accident Diastole Diastolic blood pressure Hypertension, systolic Hypertensive disease Patients Pharmacology Renal Insufficiency Scientific Publication Systolic Pressure Ventricular hypertrophy torr |
| Content Type | Text |
| Resource Type | Article |
