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Hypertension in 2010: new challenges in blood pressure goals and assessment
1Vascular Biology and Hypertension Program, Division of Cardiovascular Disease, Department of Medicine, School of Medicine, University of Alabama at Birmingham, 703 19th Street South, Birmingham, AL 35294, USA. soparil@uab.edu
Insights
New studies reveal that intensive blood pressure (BP) control in high-risk diabetes patients offers no major cardiovascular benefits beyond stroke reduction. Blood pressure variability is crucial for hypertension diagnosis and management, pending guideline updates.
Area of Science:
- Cardiology
- Nephrology
- Endocrinology
Background:
- Intensive blood pressure (BP) control (systolic BP <120 mmHg) is often recommended for high-risk patients with diabetes mellitus.
- The cardiovascular benefits and implications of BP variability in hypertension management require further investigation.
Purpose of the Study:
- To evaluate the cardiovascular benefits of tight BP control in patients with diabetes mellitus.
- To assess the significance of BP variability in hypertension diagnosis and management.
Main Methods:
- Analysis of recent provocative studies on BP control in high-risk diabetes patients.
- Review of literature concerning the role of BP variability in hypertension.
Main Results:
- Tight BP control (<120 mmHg systolic) in high-risk diabetes patients showed no significant cardiovascular benefit beyond stroke reduction.
- Blood pressure variability emerged as an important factor for diagnosing and managing hypertension.
Conclusions:
- Current intensive BP targets may not provide broad cardiovascular benefits for diabetic patients.
- The clinical significance of BP variability necessitates further evaluation for future hypertension guidelines.
Abstract:
Provocative new studies have shown that tight blood pressure (BP) control (goal systolic BP <120 mmHg) in high-risk patients with diabetes mellitus confers no significant cardiovascular benefit other than stroke reduction, and that BP variability is important for the diagnosis and management of hypertension. the impact of these findings on future hypertension guidelines remains to be assessed.
