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Optimal blood pressure: how low should we go?
1Department of Preventive Medicine, Rush-Presbyterian-St. Luke's Medical Center, Rush Medical College of Rush University, Chicago, Illinois 60612, USA. Henry_Black@rsh.net
American Journal of Hypertension
|December 22, 1999
Summary
Aggressively treating high blood pressure (hypertension) to achieve lower diastolic blood pressure (DBP) goals is safe and effective. This approach significantly reduces cardiovascular and cerebrovascular risks for patients.
Area of Science:
- Cardiovascular Medicine
- Hypertension Research
- Clinical Trials
Background:
- Hypertension is defined as systolic blood pressure >=140 mm Hg or diastolic blood pressure (DBP) >=90 mm Hg.
- Elevated blood pressure significantly increases morbidity and mortality risks.
- Effective blood pressure reduction is crucial for mitigating these risks.
Purpose of the Study:
- To evaluate the safety and efficacy of aggressive antihypertensive treatment in achieving defined blood pressure goals.
- To assess the feasibility of reaching lower DBP targets (< or =90, < or =85, and < or =80 mm Hg).
Main Methods:
- The Hypertension Optimal Treatment (HOT) trial assigned patients to different DBP target groups.
- Aggressive antihypertensive medication regimens were employed to meet these targets.
- Over 90% of patients achieved the goal DBP of < or =90 mm Hg.
Main Results:
- The study demonstrated that defined DBP goals could be safely met and exceeded.
- Aggressive treatment facilitated achievement of target blood pressure levels in a majority of patients.
- This highlights the potential for improved hypertension management.
Conclusions:
- Setting and aggressively pursuing lower blood pressure goals is essential for reducing cardiovascular and cerebrovascular risks.
- Effective antihypertensive treatment, potentially with multiple agents, is necessary for optimal patient outcomes.
- There is a gap between clinical trial results and real-world patient treatment for hypertension.