Intensive blood pressure lowering: a practical review

Clinical Hypertension

Josep Redón¹  Wook Bum Pyun²  Antonio Coca³  Miguel Camafort⁴ 

[1] Ciber-OBN, Instituto de Salud Carlos III, Madrid, Spain;Hypertension Clinic. Hospital Clinico, University of Valencia, Valencia, Spain;Department of Cardiology, Ewha Womans University. Seoul Hospital, Seoul, South Korea;Department of Internal Medicine-ICMiD. Hospital Clínic, University of Barcelona, Villarroel 170, 08036, Barcelona, Spain;Cardiovascular Risk, Nutrition and Aging Research Group. IDIBAPS, Barcelona, Spain;Department of Internal Medicine-ICMiD. Hospital Clínic, University of Barcelona, Villarroel 170, 08036, Barcelona, Spain;Cardiovascular Risk, Nutrition and Aging Research Group. IDIBAPS, Barcelona, Spain;Ciber-OBN, Instituto de Salud Carlos III, Madrid, Spain;

关键词: Intensive blood pressure lowering;    Ageing;    Obesity, cardiovascular risk;    Diabetes mellitus type 2;    Ischemic heart disease;    Chronic kidney disease;    Heart failure;    Ambulatory blood pressure measurement;   

DOI  :  10.1186/s40885-020-00153-z

来源: Springer

【 摘 要 】

According to the last Hypertension guideline recommendations, it may be concluded that intensive BP lowering is only advisable in a subgroup of patients where there is a clear net benefit of targeting to lower BP goals. However, taking into account the relevance of correct BP measurement, estimates of the benefits versus the harm should be based on reliable office BP measurements and home BP measurements.There is still debate about which BP goals are optimal in reducing morbidity and mortality in uncomplicated hypertensives and in those with associated comorbidities. In recent years, trials and meta-analyses have assessed intensive BP lowering, with some success. However, a careful examination of the results shows that current data are not easily applicable to the general hypertensive population.This article reviews the evidence on and controversies about intensive BP lowering in general and in specific clinical situations, and the importance of obtaining reliable BP readings in patients with hypertension and comorbidities.

【 授权许可】

CC BY