Mancia, G. et al. Reappraisal of European guidelines on hypertension management: a European Society of Hypertension Task Force document. J. Hypertens. 27, 2121-2158

Clinica Medica, University of Milano-Bicocca, Ospedale San Gerardo, Monza, Milan, Italy.
Journal of Hypertension (Impact Factor: 4.72). 10/2009; 27(11):2121-58. DOI: 10.1097/HJH.0b013e328333146d
Source: PubMed
Download full-text


Available from: Krzysztof Narkiewicz,
  • Source
    • "Office blood pressure was measured twice either with a mercury sphygmomanometer or an aneroid sphygmomanometer (Welch Allyn Silver Series DS45, Skaneateles Falls, NY, USA) and the average value was used. The patients were grouped as hypertension if they are diagnosed hypertension based on blood pressure following current guidelines publishedby the European Society of Hypertension18 or they are currently taking blood pressure lowering medications. The patients who do not belong to above category were grouped as non-hypertensives. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Purpose Obstructive sleep apnea (OSA) is considered an independent risk factor for hypertension. However, it is still not clear which clinical factors are related with the presence of hypertension in OSA patients. We aimed to find different physical features and compare the sleep study results which are associated with the occurrence of hypertension in OSA patients. Materials and Methods Medical records were retrospectively reviewed for patients diagnosed with OSA at Severance Cardiovascular Hospital between 2010 and 2013. Males with moderate to severe OSA patients were enrolled in this study. Clinical and polysomnographic features were evaluated to assess clinical variables that are significantly associated with hypertension by statistical analysis. Results Among men with moderate to severe OSA, age was negatively correlated with hypertension (odds ratio=0.956), while neck circumference was positively correlated with the presence of hypertension (odds ratio=1.363). Among the polysomnographic results, the lowest O2 saturation during sleep was significantly associated with the presence of hypertension (odds ratio=0.900). Conclusion Age and neck circumference should be considered as clinically significant features, and the lowest blood O2 saturation during sleep should be emphasized in predicting the coexistence or development of hypertension in OSA patients.
    Yonsei Medical Journal 09/2014; 55(5):1310-7. DOI:10.3349/ymj.2014.55.5.1310 · 1.29 Impact Factor
  • Source
    • "The choice of antihypertensive treatment, particularly for the firstline agent, should be made with caution as it could significantly affect clinical outcomes [13]. Existing guidelines, including those of the National Institute for Health and Clinical Excellence (NICE), the updated Eighth Joint National Committee (JNC 8th), and the reappraisal of the European hypertension guidelines in 2008 all recommended angiotensinconverting-enzyme (ACE) inhibitors as one of the preferred first-line agent for management of arterial hypertension [14] [15] [16] [17]. Nevertheless, there have not been explicit recommendations on which ACE inhibitor is more preferred. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: Perindopril and lisinopril are two common ACE inhibitors prescribed for management of hypertension. Few studies evaluated their comparative effectiveness to reduce mortality. This study compared the all-cause and cardiovascular related mortality among patients newly prescribed ACE inhibitors. Methods: All adult patients newly prescribed perindopril or lisinopril from 2001 to 2005 in all public clinics or hospitals in Hong Kong were retrospectively evaluated, and followed up until 2010. Patients prescribed the ACE inhibitors for less than a month were excluded. The all-cause and cardiovascular-specific (i.e. coronary heart disease, heart failure and stroke) mortality were compared. Cox proportional hazard regression model was used to assess the mortality, controlling for age, sex, socioeconomic status, patient types, the presence of comorbidities, and medication adherence as measured by the Proportion of Days Covered. An additional model using propensity scores were performed to minimize indication bias. Results: A total of 15,622 patients were included in this study, in which 6,910 were perindopril users and 8,712 lisinopril users. The all-cause mortality (22.2% vs. 20.0%, p<0.005) and cardiovascular mortality (6.5% vs. 5.6%, p<0.005) were higher among lisinopril users than perindopril users. From regression analyses, lisinopril users were 1.09-fold (95% C.I. 1.01-1.16) and 1.18-fold (95% C.I. 1.02-1.35) more likely to die from any-cause and cardiovascular diseases, respectively. Age-stratified analysis showed that this significant difference was observed only among patients aged>70 years. The additional models controlled for propensity scores yielded comparable results. Conclusions: The long-term all-cause and cardiovascular related mortality of lisinopril users was significantly different from that of perindopril users. These findings showed the intra-class variation on mortality exists among ACE inhibitors among those aged 70 years or older. Future studies should consider a longer, large-scale randomized controlled trial to compare the effectiveness between different medications in the ACEI class, especially among the elderly.
    International Journal of Cardiology 07/2014; 176(3). DOI:10.1016/j.ijcard.2014.07.114 · 4.04 Impact Factor
  • Source
    • "Several studies found that low systolic blood pressure (b120 mmHg) at baseline was associated with increased risks of all-cause and cardiovascular morality and HF hospitalizations among patients with a history of HF [28] [29] [30]. Some other studies suggest that low systolic blood pressure (b120 mmHg) might increase cardiovascular risk by the under perfusion of vital organs [31]. An impaired coronary circulation may be particularly sensitive to decreases in diastolic blood pressure [32]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: Blood pressure (BP) control has been shown to reduce the risk of heart failure (HF) among diabetic patients; however, it is not known whether the lowest clinical BP achieved ultimately results in the lowest risk of HF in diabetic patients. Methods: We performed a prospective cohort study which included 17,181 African American and 12,446 white diabetic patients without established coronary heart disease and HF at diabetes diagnosis. Cox proportional hazards regression models were used to estimate the association of different levels of BP stratification with incident HF. Results: During a mean follow up of 6.5 years, 5,089 incident HF cases were identified. The multivariable-adjusted hazard ratios of HF associated with different levels of systolic/diastolic BP (<110/65, 110-119/65-69, 120-129/70-80, 130-139/80-90 [reference group], 140-159/90-100, and ≥ 160/100 mmHg) were 1.79 (95% confidence interval [CI] 1.53-2.11), 1.34 (95% CI 1.16-1.53), 1.02 (95% CI 0.92-1.13), 1.00, 1.04 (95% CI 0.95-1.12), and 1.26 (95% CI 1.16-1.37) using baseline BP measurements, and 2.63 (95% CI 2.02-3.41), 1.84 (95% CI 1.59-2.13), 1.25 (95% CI 1.14-1.37), 1.00, 1.11 (95% CI 1.03-1.19), and 1.32 (95% CI 1.20-1.44) using an updated mean value of BP during follow-up, respectively. The U-shaped association was confirmed in both patients who were and were not taking antihypertensive drugs, and in incident systolic HF (ejection fraction ≤ 40%) and incident HF with a preserved ejection fraction (ejection fraction >40%). Conclusions: The current study suggests a U-shaped association between observed BP and the risk of HF among diabetic patients.
    International Journal of Cardiology 07/2014; 176(1). DOI:10.1016/j.ijcard.2014.06.051 · 4.04 Impact Factor
Show more