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Advantages of blood pressure optimization.
Bernard M Y Cheung1, Yu Bun Manil, Hung Fat Tse
1Department of Medicine, University of Hong Kong, Hong Kong.
Advances in Therapy
|January 19, 2006
Summary
Optimal blood pressure control is feasible and safe for hypertension patients, though it did not significantly improve target-organ damage markers like left ventricular mass or endothelial function in this 6-month study.
Area of Science:
- Cardiology
- Hypertension Management
Background:
- Lowering blood pressure (BP) is crucial for reducing cardiovascular events.
- Aggressive BP management strategies require careful evaluation for potential risks and benefits.
Purpose of the Study:
- To compare optimal BP control (<120/80 mm Hg) versus conventional BP control (<140/90 mm Hg) in hypertensive patients.
- To assess the impact of these BP control strategies on target-organ damage and tolerability over 6 months.
Main Methods:
- A randomized trial involving 23 hypertensive patients assigned to optimal or conventional therapy.
- Therapy initiated with lercanidipine, with dose adjustments or additions as needed.
- Evaluated target-organ damage using left ventricular mass (LVM) index, flow-mediated dilatation (FMD), and urinary albumin excretion.
Main Results:
- Both groups achieved significant BP reduction; optimal therapy resulted in a significantly lower diastolic BP.
- No significant changes in LVM or FMD were observed in either group.
- Optimal therapy group showed a significant increase in urinary albumin excretion; B-type natriuretic peptide (BNP) decreased in both groups.
Conclusions:
- Optimizing BP control is feasible, safe, and well-tolerated in hypertensive patients.
- Larger, longer-duration studies are needed to confirm improvements in LVM and endothelial function.
- The study highlights the need for further research into the long-term effects of aggressive BP lowering on organ damage.