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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
PubMed

Insights

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.

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