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The broadening landscape for hypertension management
1Clinica Medica, Dipartmento di Medicina Clinica e Prevenzione, Università Milano-Bicocca, Ospedale San Gerardo, Monza, Milan, Italy.
Journal of the American Society of Hypertension : JASH
|April 23, 2010
Summary
Lowering blood pressure (BP) is key for cardiovascular health. New research highlights drugs with BP-independent benefits, potentially reducing target-organ damage and conditions like diabetes.
Area of Science:
- Cardiology
- Pharmacology
- Hypertension Management
Background:
- Office blood pressure (BP) reduction significantly lowers cardiovascular event risk in hypertensive patients.
- Home and 24-hour ambulatory BP monitoring offer crucial prognostic information.
- Optimal cardiovascular risk reduction requires controlling both office and out-of-office BP, alongside multiple risk factors.
Purpose of the Study:
- To explore antihypertensive therapies that provide BP-independent benefits.
- To investigate drugs reducing target-organ damage and associated conditions like diabetes and metabolic syndrome.
- To highlight the role of specific antihypertensive agents in long-term target-organ protection.
Main Methods:
- Review of existing studies on BP control and cardiovascular outcomes.
- Analysis of evidence on BP-independent effects of various antihypertensive drug classes.
- Examination of long-term studies on target-organ protection with specific agents.
Main Results:
- Angiotensin receptor blockers, ACE inhibitors, and calcium antagonists show lower incidence of new-onset diabetes compared to older drugs.
- Polypharmacy for comprehensive BP and risk factor control increases costs and adverse events.
- BP-independent benefits of certain antihypertensives warrant further investigation.
Conclusions:
- Antihypertensive therapy ideally targets both office and out-of-office BP, plus multiple risk factors.
- Drugs with BP-independent effects offer a promising strategy for cardiovascular risk reduction.
- Long-term target-organ protection may be a key differentiator for specific antihypertensive agents.
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