Document Detail


Fluctuation: Does Blood Pressure Variability Matter?
MedLine Citation:
PMID:  22761455     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Effective drug treatment of hypertension for prevention of fatal and non-fatal cardiovascular disease passed its 50(th) anniversary two years ago(1). Until recently, the most consistent observation among trials had been that stroke risk was directly related to the fall in blood pressure on treatment(2). Older trials established the value of anti-hypertensive drug treatment (AHT) and generally recruited disease free participants at their outset. Recent trials have focused on less healthy participants. Recruitment has been extended to those with a prior stroke, recent myocardial infarction, coronary artery disease, chronic renal disease (with or without diabetes), heart failure, combined high-risk states and the elderly (old-old). The benefit of AHT is still related to the reduction in blood pressure(3). Differences between drug classes for have been found in some, but not all trials; the differences are generally small, even if statistically significant. AHT is effective in reducing risk for those with a higher disease burden, but risk is never lowered to levels equal to those who have lower pressure without AHT and lack prior cardiovascular disease. The hands of the cardiovascular clock may slow, but never stop or reverse. It is a challenge to unmask traits that might account for the limited effectiveness of AHT in its present form.(SELECT FULL TEXT TO CONTINUE).
Authors:
Lawrence R Krakoff
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-7-3
Journal Detail:
Title:  Circulation     Volume:  -     ISSN:  1524-4539     ISO Abbreviation:  -     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-7-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Mount Sinai Medical Center, New York, NY.
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