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The broadening landscape for hypertension management

Giuseppe Mancia1

  • 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
PubMed

Insights

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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