scholarly journals Blood pressure reduction and anti‐hypertensive treatment choice: A post‐hoc analysis of the SPRINT trial

2021 ◽  
Author(s):  
João Pedro Ferreira ◽  
John Gregson ◽  
Michael Böhm ◽  
Patrick Rossignol ◽  
Faiez Zannad ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Reduction ◽  
Treatment Choice ◽  
Pressure Reduction ◽  
Post Hoc Analysis ◽  
Post Hoc

scholarly journals Aggressive blood pressure reduction in patients at high vascular risk: is it dangerous?

2012 ◽  
Author(s):  
Fabio Angeli ◽  
Gianpaolo Reboldi ◽  
Cristina Poltronieri ◽  
Giovanni Mazzotta ◽  
Marta Garofoli ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Reduction ◽  
Pressure Reduction ◽  
Vascular Risk ◽  
Current State ◽  
J Curve ◽  
Blood Pressure Goals ◽  
Optimal Blood Pressure ◽  
Meta Analyses ◽  
Post Hoc

Introduction The aim of this review was to summarize the current state of evidence regarding the optimal blood pressure goals in patients with high vascular risk. In particular, this review critically addresses the issue of the “J-curve” paradox – a hypothesis indicating that low treatment-induced blood pressure values are characterized by an increase, rather than a decrease, in the incidence of cardiovascular events. Materials and methods We reviewed evidence from studies published in peer-reviewed journals indexed in Medline, EMBASE and CINAHL that compared different BP goals. Results Post-hoc analyses of randomized trials specifically conducted to test the hypothesis of the “J-shaped curve” yielded conflicting results. However, trials directly comparing different blood pressure goals and meta-analyses showed that in-treatment blood pressure values below the usual goal of less than 140/90 mmHg improve outcomes in patients at increased vascular risk. Discussion The fear that an excessive reduction in blood pressure may be dangerous is inconsistent with the available data and probably conditioned by the adverse impact of other risk factors that may be more frequent in patients with low values of achieved blood pressure. The association between blood pressure reduction and cardiovascular risk seems to be linear and not J-shaped.

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