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Contemporary Approaches to Risk Stratification and Treatment
Author(s) -
Flack John M.
Publication year - 2010
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.24.1_supplement.313.1
Subject(s) - risk stratification , medicine , intensive care medicine , clinical trial , disease , population , kidney disease , epidemiology , clinical endpoint , environmental health
Diagnosing individuals with “hypertension” can be accomplished several ways. One approach is simply using an extreme outlier cut‐point (≥ 140/90 mm Hg) above which all individuals are considered hypertensive. A modification of this approach is to lower the level of the extreme cut‐point (≥130/80 mm Hg) in groups with known higher absolute cardiovascular‐renal risk (chronic kidney disease, diabetes mellitus). Prospective clinical trial data are not available for all high‐risk groups for which treatment decisions must be made today. Moreover, randomized, hard end‐point clinical trials though extremely important do not ask all of the important questions and are not the only source of data that merits consideration. Risk stratification, treatment, and authoritative guidelines, if practical and useful, remain an artful elixir of epidemiological data, clinical trials examining BP response and hard endpoint data, basic science and physiological investigations, genetics – and reasonable extrapolations to various population subgroups for which there may be limited clinical data. This talk will cover contemporary approaches to risk stratification, new therapeutic targets, and other practical considerations in the identification and management of the patient with hypertension.