Abstract:
OBJECTIVE:To assess the clinical relevance of regression to the mean for clinical trials and clinical practice. METHODS:MEDLINE was searched until February 2018 for randomized trials of BP lowering with over 1000 patient-years follow-up per group. We estimated baseline mean BP, follow-up mean (usual) BP amongst patients grouped by 10 mmHg strata of baseline BP, and assessed effects of BP lowering on coronary heart disease (CHD) and stroke according to these BP levels. RESULTS:Eighty-six trials (349 488 participants), with mean follow-up of 3.7 years, were included. Most mean BP change was because of regression to the mean rather than treatment. At high baseline BP levels, even after rigorous hypertension diagnosis, downwards regression to the mean caused much of the fall in BP. At low baseline BP levels, upwards regression to the mean increased BP levels, even in treatment groups. Overall, a BP reduction of 6/3 mmHg lowered CHD by 14% (95% CI 11-17%) and stroke by 18% (15-22%), and these treatment effects occurred at follow-up BP levels much closer to the mean than baseline BP levels. In particular, more evidence was available in the SBP 130-139 mmHg range than any other range. Benefits were apparent in numerous high-risk patient groups with baseline mean SBP less than 140 mmHg. CONCLUSION:Clinical practice should focus less on pretreatment BP levels, which rarely predict future untreated BP levels or rule out capacity to benefit from BP lowering in high cardiovascular risk patients. Instead, focus should be on prompt, empirical treatment to maintain lower BP for those with high BP and/or high risk.
journal_name
J Hypertensjournal_title
Journal of hypertensionauthors
Salam A,Atkins E,Sundström J,Hirakawa Y,Ettehad D,Emdin C,Neal B,Woodward M,Chalmers J,Berge E,Yusuf S,Rahimi K,Rodgers A,Blood Pressure Lowering Treatment Trialists’ Collaboration.doi
10.1097/HJH.0000000000001994subject
Has Abstractpub_date
2019-01-01 00:00:00pages
16-23issue
1eissn
0263-6352issn
1473-5598pii
00004872-201901000-00007journal_volume
37pub_type
杂志文章abstract:OBJECTIVE:There is ongoing discussion on how best to screen for diabetes mellitus. Previous studies suggest that an abnormal oral glucose tolerance test (OGTT) is better than fasting glucose levels in predicting cardiovascular mortality, which is largely determined by macrovascular complications in type 2 diabetes. We ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e32834e38b6
更新日期:2012-01-01 00:00:00
abstract:OBJECTIVES:To compare the reproducibility of clinic and ambulatory blood pressure measurements in elderly hypertensive subjects. SUBJECTS:Twenty-two untreated elderly hypertensives, with a clinic systolic blood pressure (SBP) > 160 mmHg and/or diastolic blood pressure (DBP) > 95 mmHg, and a mean age of 76 years (range...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199305000-00014
更新日期:1993-05-01 00:00:00
abstract:OBJECTIVE:In this randomized, double-blind, crossover study, the antihypertensive efficacy of amlodipine and nifedipine gastrointestinal therapeutic system (GITS) was compared following missed doses. Design and methods In a randomized crossover design, 42 patients were randomized to receive amlodipine (5-10 mg) or the ...
journal_title:Journal of hypertension
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00004872-200202000-00025
更新日期:2002-02-01 00:00:00
abstract::The purpose of this study was to examine pressor responsiveness in a rabbit model with adrenal perturbation. Adrenals in rabbits were stabbed with a needle, and the rabbits were given water (adrenal-water group) or 0.9% NaCl (adrenal-salt) to drink; additional rabbits were sham-operated and given water (sham-water gro...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-198502000-00014
更新日期:1985-02-01 00:00:00
abstract:BACKGROUND:Some patients with essential hypertension manifest greater than normal urinary excretion of albumin (UAE). Authors of a few retrospective studies have suggested that there is an association between microalbuminuria and cardiovascular risk. OBJECTIVE:To evaluate whether microalbuminuria is associated with a ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199816090-00014
更新日期:1998-09-01 00:00:00
abstract:OBJECTIVES:Our aims were to assess the progression rate of normotension and prehypertension to hypertension in Japan, and the effect of the new-onset hypertension on chronic kidney disease (CKD). METHODS:This was a nationwide study of 45 378 Japanese aged 40-74 years (mean age 60 years, 37% men) without hypertension o...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000000344
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:Little data is available concerning the prognostic implications of renal function abnormalities, their evolution over time and the effects of nifedipine on such abnormalities in patients with stable angina pectoris. METHODS:The previously published ACTION trial compared long-acting nifedipine GITS 60 mg onc...
journal_title:Journal of hypertension
pub_type: 杂志文章,随机对照试验
doi:10.1097/HJH.0b013e3281c49d93
更新日期:2007-08-01 00:00:00
abstract:BACKGROUND:Enhanced oxidative stress has been observed in hypertension, but the underlying mechanism has not been fully clarified. OBJECTIVE:To study the relationship between oxygen free radicals and hypertension, using platelets as a tool to measure the cellular production of superoxide anion (O2). DESIGN:Forty pati...
journal_title:Journal of hypertension
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00004872-200406000-00016
更新日期:2004-06-01 00:00:00
abstract::: The 2008 European Society of Cardiology/European Society of Hypertension guidelines recommend the first-line prescription of two antihypertensive drugs in single-pill combinations (SPCs), also known as fixed-dose combinations, for the treatment of most patients with hypertension. This recommendation is based on a la...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000002598
更新日期:2020-12-01 00:00:00
abstract::6-Hydroxydopamine (6-OHDA) was injected on alternate days from birth to 3 weeks of age into spontaneously hypertensive (SHR) and normotensive Wistar-Kyoto (WKY) control rats. The effects of this neonatal treatment on cardiovascular structure and mesenteric resistance vessel calcium sensitivity was studied in young (6 ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-198608000-00010
更新日期:1986-08-01 00:00:00
abstract:BACKGROUND:Epidemiological investigations have demonstrated a close association between heavy alcohol consumption and hypertension. The mechanisms of this association, however, remain elusive. We studied the effects of alcohol withdrawal on blood pressure, hormonal parameters, and circulating markers of endothelial act...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/01.hjh.0000239283.35562.15
更新日期:2006-08-01 00:00:00
abstract:BACKGROUND:Fibromuscular dysplasia (FMD) and atherosclerotic renal artery stenosis (ARAS) are the most common causes of renovascular hypertension. So far, FMD is believed to cause hypertension via similar mechanisms as in ARAS, that is, a decrease in renal blood flow, which subsequently leads to increased renin secreti...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000001243
更新日期:2017-04-01 00:00:00
abstract:OBJECTIVES:Patients with chronic renal failure are restricted to mild physical activity and tend to a lack of exercise. However, there have been few reports regarding the influence of chronic exercise on the progression of renal disease. Similarly, there are few animal models concerned with the effect of exercise train...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-200110000-00024
更新日期:2001-10-01 00:00:00
abstract:AIM:To examine the effect of renal denervation (RDN) on blood pressure (BP) and health-related quality of life (QoL) in patients with resistant hypertension, pseudoresistant hypertension due to a white-coat effect and in patients with uncontrolled masked hypertension. METHODS:Using the Medical Outcomes Study 36-Item S...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000000698
更新日期:2015-11-01 00:00:00
abstract:OBJECTIVES:To investigate whether combined treatment with lisinopril, an angiotensin-converting enzyme (ACE) inhibitor and exercise training would have an additive effect in enhancing the capillary supply of the left ventricular (LV) myocardium in spontaneously hypertensive rats (SHR). DESIGN:Twelve-week-old male SHR ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/01.hjh.0000170387.61579.ab
更新日期:2005-06-01 00:00:00
abstract:OBJECTIVE:During the Candesartan Antihypertensive Survival Evaluation in Japan (CASE-J) trial, patients with hypertension who received amlodipine had similar cardiovascular risks as those who received candesartan. We conducted a post-trial study, the Candesartan Antihypertensive Survival Evaluation in Japan 10-year fol...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000001780
更新日期:2018-09-01 00:00:00
abstract:OBJECTIVE:Reversibility of the systemic and renal alterations induced by N(omega)-nitro-L-arginine-methyl ester(L-NAME) was assessed by treatment with irbesartan and enalapril (30 and 10 mg/kg per 24 h, respectively) alone or in combination. DESIGN:L-NAME (20 mg/kg per 24 h) was given to rats for 6 weeks and treatment...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-200111000-00015
更新日期:2001-11-01 00:00:00
abstract:BACKGROUND:A recent editorial published by Verma and Strauss, entitled 'Angiotensin receptor blockers and myocardial infarction', examined, through a partial analysis of individual trials, the use of angiotensin receptor blockers (ARBs) in a variety of clinical settings. This editorial was reported widely in the lay pr...
journal_title:Journal of hypertension
pub_type: 杂志文章,meta分析,评审
doi:10.1097/01.hjh.0000194114.12228.16
更新日期:2005-12-01 00:00:00
abstract:OBJECTIVES:To determine whether vigorous exercise and alcohol restriction have additive and independent effects in reducing blood pressure in sedentary male alcohol drinkers. Also to assess whether 4 weeks of vigorous exercise could offset the fall in high-density lipoprotein cholesterol (HDL-cholesterol) usually obser...
journal_title:Journal of hypertension
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00004872-199302000-00012
更新日期:1993-02-01 00:00:00
abstract:BACKGROUND:Widely evaluated regarding the genetic make-up of essential hypertension are the renin-angiotensin-aldosterone system (RAAS) genes polymorphisms, whereas results are often not reproducible. METHOD:We thus focused on a large Fangshan population to explore association of thirteen polymorphisms in five genes o...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e32832b7e0d
更新日期:2009-07-01 00:00:00
abstract:OBJECTIVES:To establish whether safety and feasibility of dobutamine and dipyridamole stress echocardiography are affected by history of hypertension. METHODS:Data on 2200 consecutive pharmacologic stress echocardiography (959 dobutamine and 1241 dipyridamole) performed between October 1990 and February 2001 at a sing...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-200207000-00030
更新日期:2002-07-01 00:00:00
abstract::We have examined the mechanisms mediating the release of renin elicited in man by reduction of renal perfusion pressure. Fifteen patients with essential hypertension and six normotensive subjects were investigated during diagnostic renal arteriography. Renal neural receptors were inhibited by propranolol (10 mg i.v.) ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-198502000-00007
更新日期:1985-02-01 00:00:00
abstract:OBJECTIVE:To determine whether obese hypertensive patients manifest a diminished regional vasodilator response to an oral glucose challenge. METHODS:Nineteen obese hypertensives (body mass index 34.1 +/- 1.3 kg/m2, blood pressure 144 +/- 3/96 +/- 2 mmHg) and 13 lean controls (23.6 +/- 0.3 kg/m2, 127 +/- 4/83 +/- 3 mmH...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:
更新日期:1994-09-01 00:00:00
abstract:OBJECTIVE:To investigate gender-dependent difference in the free cytosolic calcium concentration ([Ca2+ ]i ) response to angiotensin II (Ang II) in vascular smooth muscle cells (VSMC) isolated from spontaneously hypertensive rats (SHR). To further evaluate this gender-dependent difference by studying the role of thapsi...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-200211000-00021
更新日期:2002-11-01 00:00:00
abstract:BACKGROUND:Cathepsin L (CTSL1) catalyzes the formation of peptides that influence blood pressure (BP). Naturally occurring genetic variation or targeted ablation of the Ctsl1 locus in mice yield cardiovascular pathology. Here, we searched for genetic variation across the human CTSL1 locus and probed its functional effe...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e328356b86a
更新日期:2012-10-01 00:00:00
abstract::: High blood pressure (BP) is a highly prevalent modifiable cause of cardiovascular disease, stroke, and death. Accurate BP measurement is critical, given that a 5-mmHg measurement error may lead to incorrect hypertension status classification in 84 million individuals worldwide. This position statement summarizes pro...
journal_title:Journal of hypertension
pub_type: 杂志文章,实务指引
doi:10.1097/HJH.0000000000002112
更新日期:2019-09-01 00:00:00
abstract:BACKGROUND:Recent cross-sectional studies have suggested that higher serum sodium levels may be a marker of elevated blood pressure. It is unclear whether serum sodium levels are related to the risk of developing hypertension in the community. METHODS:We investigated the association of serum sodium with longitudinal b...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e32830fe4a5
更新日期:2008-11-01 00:00:00
abstract::Recently, there has been an explosion of knowledge on vasopressin, including its neuro-anatomy, biochemistry and physiology. Recent work demonstrates extensive extra-hypothalamic vasopressinergic projections from the SON and PVN. Of particular importance are projections to the cardiovascular medullary centres. Convers...
journal_title:Journal of hypertension
pub_type: 杂志文章,评审
doi:10.1097/00004872-198512000-00001
更新日期:1985-12-01 00:00:00
abstract::We have demonstrated high concentrations of inactive renin in mouse amniotic fluid compared with mouse plasma and other organs. Its molecular weight was similar to that of prorenin from the mouse submaxillary gland (42 000 daltons). The activated renin had a Km value of 1.48 greater than M which is identical to that o...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-198410000-00012
更新日期:1984-10-01 00:00:00
abstract:OBJECTIVES:Unlike the 2018 European Society of Cardiology/European Society of Hypertension (ESC/ESH) guideline, the 2017 American College of Cardiology/American Heart Association (ACC/AHA) guideline has recommended a shift in hypertension definition from blood pressure (BP) 140/90-130/80 mmHg. Further, they proposed so...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000002065
更新日期:2019-07-01 00:00:00