Abstract:
:Sixty-eight blood pressure (BP)-lowering randomized controlled trials (defined as randomized controlled trials comparing active treatment with placebo, or less active treatment, achieving a BP difference, performed between 1966 and end 2013 in cohorts with ≥ 40% hypertensive patients, and exclusive of trials in acute myocardial infarction, heart failure, acute stroke, and dialysis) were identified and meta-analyzed grouping the randomized controlled trials on the basis of clinically relevant questions: (1) does BP lowering reduce all types of cardiovascular outcome? (2) Is prevention of all outcomes proportional to the extent of systolic, diastolic, and pulse BP? (3) Have all classes of BP-lowering drugs been shown capable of reducing all types of cardiovascular outcome? (4) Is BP lowering beneficial when intervention is initiated at any grade (or stage) of hypertension? (5) Do BP-lowering randomized controlled trials provide evidence about systolic BP and diastolic BP targets of treatment? (6) Should BP-lowering treatment be preferentially addressed to patients in higher risk categories promising larger absolute treatment benefits? The results of these meta-analyses provide further support to current hypertension treatment guidelines by showing that BP lowering can significantly reduce major cardiovascular outcomes largely independent of the agents used, significant risk reduction is found at all hypertension grades (stages), and when systolic BP is lowered below a cut off of 140 mm Hg with some further reduction limited to stroke at systolic BP values just <130 mm Hg. Absolute risk reduction progressively increases higher is total cardiovascular risk, but this greater benefit is associated with a progressively higher residual risk, ie, higher treatment failures.
journal_name
Circ Resjournal_title
Circulation researchauthors
Zanchetti A,Thomopoulos C,Parati Gdoi
10.1161/CIRCRESAHA.116.303641subject
Has Abstractpub_date
2015-03-13 00:00:00pages
1058-73issue
6eissn
0009-7330issn
1524-4571pii
CIRCRESAHA.116.303641journal_volume
116pub_type
杂志文章,评审abstract::Mechanoreceptors and chemoreceptors have been identified inside the kidney, but their functional role is still largely unclear. The aim of this study was to investigate whether changes in urine output could modify the discharge rate of renal afferent fibers. Experiments were performed in anesthetized cats in which aff...
journal_title:Circulation research
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abstract::In adult mammals, massive sudden loss of cardiomyocytes after infarction overwhelms the limited regenerative capacity of the myocardium, resulting in the formation of a collagen-based scar. Necrotic cells release danger signals, activating innate immune pathways and triggering an intense inflammatory response. Stimula...
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journal_title:Circulation research
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更新日期:1982-12-01 00:00:00
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journal_title:Circulation research
pub_type: 杂志文章
doi:10.1161/01.res.72.4.827
更新日期:1993-04-01 00:00:00
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pub_type: 杂志文章
doi:10.1161/CIRCRESAHA.116.308825
更新日期:2017-04-14 00:00:00
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journal_title:Circulation research
pub_type: 杂志文章
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更新日期:1987-04-01 00:00:00
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更新日期:1995-03-01 00:00:00
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journal_title:Circulation research
pub_type: 杂志文章,评审
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更新日期:2003-12-12 00:00:00
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journal_title:Circulation research
pub_type: 杂志文章
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更新日期:1986-06-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2012-01-06 00:00:00
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更新日期:2004-04-16 00:00:00
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pub_type: 杂志文章
doi:10.1161/01.res.43.1.72
更新日期:1978-07-01 00:00:00
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更新日期:2004-03-19 00:00:00
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journal_title:Circulation research
pub_type: 杂志文章
doi:10.1161/01.res.77.5.869
更新日期:1995-11-01 00:00:00
abstract::To study whether atrial fibrillation might produce local changes in the atrium which could facilitate the tendency of this arrhythmia to become chronic and self-perpetuating, we compared the effect of atrial fibrillation, atrial pacing, and acute volume loading on the perfusion and oxygen consumption of the atrium in ...
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pub_type: 杂志文章
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更新日期:1982-08-01 00:00:00
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pub_type: 杂志文章
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更新日期:1987-07-01 00:00:00
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journal_title:Circulation research
pub_type: 杂志文章
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更新日期:1982-09-01 00:00:00
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journal_title:Circulation research
pub_type: 杂志文章
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更新日期:2007-12-07 00:00:00
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更新日期:1981-08-01 00:00:00
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更新日期:2020-07-31 00:00:00
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更新日期:2005-11-11 00:00:00
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pub_type: 杂志文章
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更新日期:2008-06-20 00:00:00
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更新日期:1983-03-01 00:00:00
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更新日期:2013-11-08 00:00:00
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更新日期:2005-08-19 00:00:00
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pub_type: 杂志文章
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更新日期:2011-10-14 00:00:00