Facts and fallacies of blood pressure control in recent trials: implications in the management of patients with hypertension

Alberto Zanchetti, Giuseppe Manci, Henry R. Black, Suzanne Oparil, Bernard Waeber, Roland E. Schmieder, George L. Bakris, Franz H. Messerli, Sverre E. Kjeldsen, Luis M. Ruilope

Research output: Contribution to journalArticle

Abstract

A large body of clinical trial data indicates that a given difference in blood pressure (BP), as measured in the clinic, results in a given difference in outcome. This correlation underpins current US and European guidelines for the management of hypertension. However, findings fromrecent comparative trials may appear inconsistent with a fixed relationship between BP lowering and outcome benefit, at least at all BP ranges, at all levels of total cardiovascular risk and with all drug combinations. We review the findings of six of these recent trials and conclude that their complex design precludes a simple interpretation, that several important questions remain unanswered and that direct evidence - particularly in support of lowering systolic BP below 140 or 130mmHg - is urgently needed.

Original languageEnglish
Pages (from-to)673-679
Number of pages7
JournalJournal of Hypertension
Volume27
Issue number4
DOIs
Publication statusPublished - Apr 2009

Keywords

  • Antihypertensive agents
  • Blood pressure determination
  • Cardiovascular diseases
  • Hypertension

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

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    Zanchetti, A., Manci, G., Black, H. R., Oparil, S., Waeber, B., Schmieder, R. E., Bakris, G. L., Messerli, F. H., Kjeldsen, S. E., & Ruilope, L. M. (2009). Facts and fallacies of blood pressure control in recent trials: implications in the management of patients with hypertension. Journal of Hypertension, 27(4), 673-679. https://doi.org/10.1097/HJH.0b013e3283298ea2