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Are there benefits of antihypertensive therapy beyond blood pressure lowering?
MedLine Citation:
PMID:  20978874     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
Meta-analyses strongly suggest that the primary preventive benefit of antihypertensive therapy in uncomplicated individuals is the direct result of the lower blood pressure (BP) rather than the choice of agents. In contrast, when comorbidities are present, therapeutic benefit is governed primarily by the appropriateness of the drug class for the comorbidity profile. As progressively lower BP levels are studied, conflicting results and uncertainties continue to emerge. Given the geometric nature of the BP-risk relationship, it is to be expected that benefits will be less dramatic at lower levels of BP. Conflicting results may emerge from intrinsic problems with clinical trials, including uncertainties related to confounded composite end points, interactions of comorbidities, selection bias from the heterogeneous population with hypertension, interindividual response differences, BP variation and measurement artifacts, multiple mechanisms of antihypertensive drugs, and other deficiencies in study design. The mandate for BP reduction remains strong in virtually all clinical situations. Because of clinical heterogeneity, however, no single drug class is preferred in all circumstances.
Authors:
Joseph L Izzo
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Current hypertension reports     Volume:  12     ISSN:  1534-3111     ISO Abbreviation:  Curr. Hypertens. Rep.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100888982     Medline TA:  Curr Hypertens Rep     Country:  United States    
Other Details:
Languages:  eng     Pagination:  440-7     Citation Subset:  IM    
Affiliation:
Erie County Medical Center, State University of New York at Buffalo, 462 Grider Street, Buffalo, NY 14215, USA. jizzo@buffalo.edu
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