This post-hoc analysis of the Treating to New Targets (TNT) study evaluated the joint effects of managing low-density lipoprotein cholesterol (LDL-C) and systolic blood pressure (SBP) on cardiovascular outcomes. Patients (N=9739) with clinically evident, stable coronary heart disease (CHD) were randomized to atorvastatin 10 or 80 mg/d. The primary end point was occurrence of a first major cardiovascular event. At 3 months' follow-up, patients were stratified according to SBP (< 140 mm Hg vs > or = 140 mm Hg) and tertiles of LDL-C. At 4.9 years' median follow-up, the rate of major cardiovascular events was reduced most in patients with lower LDL-C (P < .001) and in patients with SBP < 140 mm Hg (P = .014). A 42% relative risk reduction was observed for patients in the lowest LDL-C tertile with an SBP < 140 mm Hg, compared with patients in the highest LDL-C tertile with an SBP > or = 140 mm Hg. The effect of lower SBP on stroke was most pronounced in the lowest LDL-C tertile.
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http://dx.doi.org/10.1111/j.1751-7176.2008.07851.x | DOI Listing |
Am J Hypertens
December 2024
Center for Behavioral Cardiovascular Health, Department of Medicine, Columbia University Irving Medical Center.
Background: Clinical inertia is common when blood pressure (BP) is high in the office. Little is known about the extent of clinical inertia after ambulatory BP monitoring (ABPM).
Methods: This was an electronic health record-based retrospective cohort study of patients with high office BP (≥140/90 mmHg) referred for ABPM at a medical center in New York City between 2016 and 2020.
Acute electrical stimulation of the common peroneal nerve (cPNS) has been shown to cause an immediate reduction in systolic blood pressure (SBP) in spontaneous hypertense rats (SHR), but the effect of this treatment in sub-chronic ambulatory SBP is unknown. Here we developed an implantable wireless WNClip neural stimulator to test the efficacy of 5-week cPNS as a treatment for hypertension. Daily cPNS 2 Hz monophasic stimulation at threshold for 8 minutes every day for five weeks, reduced SBP in WKY animals by -4 mm Hg, and in SHR animals by -21 mmHg in week 5 (p < 0.
View Article and Find Full Text PDFEur J Intern Med
December 2024
SUNY Downstate College of Medicine, New York, NY, USA.
Background: There is a paucity of data investigating the impact of antihypertensive drug classes and blood pressure (BP) treatment targets on the incidence of end-stage kidney disease (ESKD). In patients with high-risk hypertension aged 50-80 years or above, we aimed to, 1) compare effects of valsartan, an angiotensin receptor blocker, with amlodipine, a calcium channel blocker and, 2) assess the effect of achieving systolic BP <135 vs ≥135 mmHg on the ESKD incidence.
Methods: The VALUE Trial was a multicenter prospective double-blinded randomized clinical trial in patients with essential hypertension and high cardiovascular risk including known coronary disease, left ventricular hypertrophy and previous stroke, in which ESKD was a secondary endpoint defined as progression to kidney transplant and/or dialysis.
Patient Prefer Adherence
December 2024
Endocrinology Department, the Affiliated Suzhou Hospital of Nanjing University Medical School, Jiangsu, People's Republic of China.
Objective: Medicine is critical for blood-pressure control in patients with type 2 diabetes mellitus (T2DM), for evaluation of treatment patterns and effects would offer baselines for future health services.
Methods: A cross-sectional study was conducted from August 2018 to January 2021 in the urban-rural fringe zone of Suzhou City, Jiangsu Province, China. Blood pressure and antihypertensive medication use were collected from T2DM patients combined with hypertension (HTN).
J Nephrol
December 2024
Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
Background: We evaluated the proportion of Type 2 diabetes (T2D) patients with chronic kidney disease (CKD) participating in the AMD (Association of Medical Diabetologists) Annals initiative who met the eligibility criteria for phase III-studies on finerenone, showing its renal and cardiovascular benefits.
Methods: This analysis involved all T2D patients seen in 2019 in 282 diabetes centers in Italy, for whom data on kidney function (estimated glomerular filtration rate and albuminuria) were available. Data are presented separately for different scenarios, covering the population with main eligibility criteria for inclusion in the FIDELIO-DKD and FIGARO-DKD trials.
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