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JACC: Considering both systolic and diastolic blood pressure, how should the control target be set?

 Last Update: 2021-11-01
 Source: Internet
 Author: User

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Systolic and diastolic blood pressure and heart vascular events have important implications, but rarely consider at the same time
.
The current guidelines set the goal of hypertension treatment below 140/90 (or 130/80) mmHg, and the goal of systolic blood pressure control for stroke prevention is lower.

At the same time, for patients with coronary heart disease, diastolic blood pressure cannot be lowered too low

Systolic and diastolic blood pressure and heart vascular events have important implications, but rarely consider at the same time
.

This study attempted to simultaneously analyze the associated risks of systolic blood pressure (SBP) and diastolic blood pressure (DBP) measurements and major comprehensive outcomes such as all-cause death, myocardial infarction (MI), congestive heart failure (CHF), or stroke

The study analyzed data from the ALLHAT trial, which randomly divided adults into chlorthalidone, amlodipine, or lisinopril

The results showed that during an average follow-up period of 4.

In summary, the study confirmed that the relationship between blood pressure and stroke is linear.

In the ALLHAT study, there is no J-shaped curve between stroke risk and systolic or diastolic blood pressure, and a linear relationship remains at the 110/55mmHg level

In summary, in summary,

In general, the risk pattern of systolic and diastolic blood pressure varies with clinical outcomes, and systolic and diastolic blood pressure are associated with the lowest risk
.
The results of this study indicate that the personalization of blood pressure goals may partly depend on the patient's most dangerous cardiovascular event, that is, which cardiovascular risk the patient faces is the highest, and it may be necessary to adopt different individualized blood pressure target values

In general, the risk pattern of systolic and diastolic blood pressure varies with clinical outcomes, and systolic and diastolic blood pressure are associated with the lowest risk

Original source:

Nathan K.

Itoga , et al.
Contributions of Systolic and Diastolic Blood Pressures to Cardiovascular Outcomes in the ALLHAT Study

Nathan K.
Itoga Contributions of Systolic and Diastolic Blood Pressures to Cardiovascular Outcomes in the ALLHAT Study

J Am Coll Cardiol .
2021 Oct , 78 (17) 1671–1678

J Am Coll Cardiol J Am Coll Cardiol .
2021 Oct 2021 Oct , 78 (17) 1671–1678

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