noviembre 2015 Archivos

Blood pressure is a potent determinant of cardiovascular risk, but the most appropriate targets for blood-pressure lowering have long been debated. Observational studies with a low risk of confounding have shown a linear relationship between blood pressure and cardiovascular risk down to 115/75 mm Hg, but some observational studies with a greater potential for confounding, involving persons at increased risk, have suggested a J-shaped curve — that is, below a given blood pressure, risk would increase. When trials of blood-pressure–lowering drugs have shown benefits in patients without hypertension, these effects have often been ascribed to alternative mechanisms. The widespread uncertainty about blood-pressure targets was increased when the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial showed no significant overall difference in cardiovascular events between patients with type 2 diabetes assigned to a systolic blood-pressure target of less than 120 mm Hg and those assigned to a target of less than 140 mm Hg.

Citado: Perkovic V, Rodgers A. Redefining Blood-Pressure Targets–SPRINT Starts the Marathon. N Engl J Med [Internet]. 2015 [citado 7 Nov 2017];373(22).

Abstract: The most appropriate targets for systolic blood pressure to reduce cardiovascular morbidity and mortality among persons without diabetes remain uncertain.We randomly assigned 9361 persons with a systolic blood pressure of 130 mm Hg or higher and an increased cardiovascular risk, but without diabetes, to a systolic blood-pressure target of less than 120 mm Hg (intensive treatment) or a target of less than 140 mm Hg (standard treatment). The primary composite outcome was myocardial infarction, other acute coronary syndromes, stroke, heart failure, or death from cardiovascular causes. Leer más…