Sergio H R Ramalho1,2, Amil M Shah3. 1. Division of Cardiovascular Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02445, USA. 2. Health Sciences and Technologies Program, University of Brasilia, Brasilia, Brazil. 3. Division of Cardiovascular Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02445, USA. ashah11@partners.org.
Abstract
PURPOSE OF REVIEW: Evaluate the relevant new findings regarding hypertension treatment and heart failure prevention published in the past 3 years. RECENT FINDINGS: In a recent secondary analysis of Systolic Blood Pressure Intervention Trial (SPRINT), randomization of more than 9000 patients > 50 years old with high cardiovascular risk but without diabetes to intensive treatment targeting blood pressure < 120/80 mmHg compared to standard treatment targeting < 140/90 mmHg significantly reduced incident heart failure. While such benefits outweighed potential harm, adverse events including renal dysfunction, hypotension, and syncope occurred more frequently with intensive treatment. Following SPRINT, existing guidelines differ in their recommendations and controversies still exist. Key persistent questions include the role of intensive treatment in younger adults and those at lower cardiovascular risk and optimal approaches to translate clinical trial findings into clinical practice in a sustainable fashion. Aggressively treating hypertension to targets below 120/80 mmHg prevents heart failure in high-risk patients. However, evidence is lacking to younger patients and those at lower cardiovascular risk.
PURPOSE OF REVIEW: Evaluate the relevant new findings regarding hypertension treatment and heart failure prevention published in the past 3 years. RECENT FINDINGS: In a recent secondary analysis of Systolic Blood Pressure Intervention Trial (SPRINT), randomization of more than 9000 patients > 50 years old with high cardiovascular risk but without diabetes to intensive treatment targeting blood pressure < 120/80 mmHg compared to standard treatment targeting < 140/90 mmHg significantly reduced incident heart failure. While such benefits outweighed potential harm, adverse events including renal dysfunction, hypotension, and syncope occurred more frequently with intensive treatment. Following SPRINT, existing guidelines differ in their recommendations and controversies still exist. Key persistent questions include the role of intensive treatment in younger adults and those at lower cardiovascular risk and optimal approaches to translate clinical trial findings into clinical practice in a sustainable fashion. Aggressively treating hypertension to targets below 120/80 mmHg prevents heart failure in high-risk patients. However, evidence is lacking to younger patients and those at lower cardiovascular risk.
Authors: Dena Ettehad; Connor A Emdin; Amit Kiran; Simon G Anderson; Thomas Callender; Jonathan Emberson; John Chalmers; Anthony Rodgers; Kazem Rahimi Journal: Lancet Date: 2015-12-24 Impact factor: 79.321
Authors: Bernard Zinman; Christoph Wanner; John M Lachin; David Fitchett; Erich Bluhmki; Stefan Hantel; Michaela Mattheus; Theresa Devins; Odd Erik Johansen; Hans J Woerle; Uli C Broedl; Silvio E Inzucchi Journal: N Engl J Med Date: 2015-09-17 Impact factor: 91.245
Authors: Sripal Bangalore; Bora Toklu; Eugenia Gianos; Arthur Schwartzbard; Howard Weintraub; Gbenga Ogedegbe; Franz H Messerli Journal: Am J Med Date: 2017-01-19 Impact factor: 4.965
Authors: Jeff D Williamson; Mark A Supiano; William B Applegate; Dan R Berlowitz; Ruth C Campbell; Glenn M Chertow; Larry J Fine; William E Haley; Amret T Hawfield; Joachim H Ix; Dalane W Kitzman; John B Kostis; Marie A Krousel-Wood; Lenore J Launer; Suzanne Oparil; Carlos J Rodriguez; Christianne L Roumie; Ronald I Shorr; Kaycee M Sink; Virginia G Wadley; Paul K Whelton; Jeffrey Whittle; Nancy F Woolard; Jackson T Wright; Nicholas M Pajewski Journal: JAMA Date: 2016-06-28 Impact factor: 56.272