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Arterial hypertension - Clinical trials update 2021
Hussam Al Ghorani1, Felix Götzinger1, Michael Böhm1
1Klinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Saarland University, Homburg, Germany.
Nutrition, Metabolism, and Cardiovascular Diseases : NMCD
|October 25, 2021
Summary
Recent hypertension clinical trials highlight key factors for cardiovascular disease risk, including onset age and nighttime blood pressure. Novel treatments like renal denervation and lifestyle modifications offer effective hypertension management strategies.
Area of Science:
- Cardiology and Epidemiology
- Clinical Trials Research
- Hypertension Management
Background:
- Recent clinical trials (2020-2021) provide critical updates on hypertension epidemiology, diagnostics, and treatment.
- Focus areas include hypertension onset, cardiovascular risk, monitoring methods, and special patient populations.
- Emerging research addresses exercise-induced hypertension, COVID-19 interactions, and nutritional impacts.
Purpose of the Study:
- To review and synthesize significant clinical trial findings in hypertension from 2020-2021.
- To discuss the implications of these findings for clinical practice and future research.
- To highlight advancements in understanding hypertension's multifaceted aspects.
Main Methods:
- Systematic review and discussion of published clinical trials.
- Analysis of data related to hypertension onset, cardiovascular disease (CVD) risk, and blood pressure monitoring.
- Evaluation of treatment strategies including lifestyle, pharmacotherapy, and interventional procedures.
Main Results:
- Hypertension onset age, nighttime blood pressure, and riser patterns are linked to future CVD risk.
- Exercise systolic blood pressure correlates with coronary heart disease risk.
- Renin-angiotensin system blockers do not increase severe COVID-19 risk.
- Intensified blood pressure control in the elderly requires individualized risk-benefit assessment.
- A J-shaped association exists between CVD and blood pressure in atrial fibrillation patients on anticoagulation.
- Salt restriction, lifestyle changes, SGLT2 inhibitors, and GLP-1 receptor agonists are effective.
- Renal denervation is a viable option for selected uncontrolled hypertension cases.
Conclusions:
- Early hypertension onset and specific blood pressure patterns predict future cardiovascular events.
- Current evidence supports renin-angiotensin system blockers in COVID-19 patients and guides elderly hypertension management.
- Lifestyle modifications and newer drug classes offer effective blood pressure control.
- Renal denervation presents a promising therapeutic avenue for resistant hypertension.
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