| 1. |
- Jekell, Andreas, et al.
(författare)
-
Treatment of hypertensive left ventricular hypertrophy
- 2018
-
Ingår i: Current Pharmaceutical Design. - : Bentham Science Publishers Ltd.. - 1381-6128 .- 1873-4286. ; 24:37, s. 4391-4396
-
Forskningsöversikt (refereegranskat)abstract
- Background: The development and risk potential of hypertension-induced left ventricular (LV) hypertrophy has been well described in epidemiological studies. Regression of LV hypertrophy reduces cardiovascular morbidity and mortality. However, the best treatment strategy is still debated, as well as the appropriate blood pressure target in these patients. Objective: We here review the treatment of LV hypertrophy and the potential benefit on clinical outcomes, against a background of the epidemiology and pathophysiology. Results: Both hemodynamic and non-hemodynamic mechanisms contribute to hypertensive LV hypertrophy, which is characterized by an inappropriate myocardial fibrosis. Stringent blood pressure control reduces LV hypertrophy. Blockers of the renin-angiotensin-aldosterone system may have valuable effects on cardiac and electrophysiological remodelling beyond the effects of blood pressure reduction. Thus, they represent a cornerstone in the treatment of hypertensive LV hypertrophy, but most often other antihypertensive drug classes need to be added. Current guidelines indicate a blood pressure target in most patients with hypertensive LV hypertrophy of 120–130/80 mmHg. Conclusions: LV hypertrophy and myocardial fibrosis are important characteristics of hypertensive heart disease and associated with untoward prognosis. Regression of LV hypertrophy reduces cardiovascular morbidity and mortality. New drugs under development may add additional benefit.
|
|
| 2. |
- Kahan, Thomas, et al.
(författare)
-
Hypertoni är största hotet mot global hälsa : ger ökad risk för framför allt hjärt–kärlsjukdom, demens och njursjukdom
- 2013
-
Ingår i: Läkartidningen. - : Läkartidningen förlag AB. - 0023-7205 .- 1652-7518. ; 110:22, s. 1088-1089
-
Tidskriftsartikel (refereegranskat)abstract
- Förhöjt blodtryck är i dag den viktigaste riskfaktorn av global betydelse för den totala sjukdomsbördan. Medelblodtrycket (åldersjusterat) sjunker i västerländska befolkningar. I Sverige beräknas omkring 2 miljoner individer ha hypertoni, och andelen ökar med en åldrande befolkning. Behandling av hypertoni ger stora behandlingsvinster. Trots detta når bara en av tre behandlade patienter i svensk sjukvård målblodtryck (lägre än 140/90 mm Hg).
|
|
| 3. |
|
|
| 4. |
- Sobieraj, Piotr, et al.
(författare)
-
Heart Failure Events in a Clinical Trial on Arterial Hypertension : New Insights into the SPRINT Trial
- 2021
-
Ingår i: Hypertension. - 0194-911X. ; 78:5, s. 1241-1247
-
Tidskriftsartikel (refereegranskat)abstract
- SPRINT (Systolic Blood Pressure Intervention Trial) showed that intensive lowering of systolic blood pressure to <120 mm Hg was beneficial, as compared with standard treatment in which systolic blood pressure is lowered to <140 mm Hg. The proposal that the results of SPRINT were mainly driven by the reduction of heart failure events has undermined the main conclusion of the study. Therefore, this study aimed to assess whether the intensive treatment group was also associated with a reduced risk of cardiovascular events when heart failure events were excluded from the primary composite end point. The SPRINT data were analyzed with a redefined composite end point including myocardial infarction, acute coronary syndrome other than myocardial infarction, stroke, and cardiovascular death (excluding heart failure events). The results show that intensive treatment (<120 mm Hg) is associated with a reduced risk for the redefined composite end point (hazard ratio, 0.79 [95% CI, 0.66-0.95]; P=0.012), as compared with the standard treatment (<140 mm Hg), and with results similar to the original SPRINT findings (hazard ratio, 0.75 [95% CI, 0.64-0.89]; P<0.001). Overall, the main results of SPRINT are not driven by a reduction in heart failure events. Moreover, this post hoc analysis supports the use of a more intensive treatment strategy for high-risk hypertensive patients.
|
|
