Open AccessThe Importance of Prompt Blood Pressure Control
Author(s) -
Basile Jan
Publication year - 2008
Publication title -
the journal of clinical hypertension
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 67
eISSN - 1751-7176
pISSN - 1524-6175
DOI - 10.1111/j.1524-6175.2007.08027.x
Subject(s) - medicine , blood pressure , post hoc analysis , calcium channel blocker , observational study , regimen , clinical trial , prehypertension , cardiology , randomized controlled trial , antihypertensive drug , intensive care medicine
Hypertension affects almost one‐third of adults in the United States, but blood pressure is adequately controlled in only about 50% to 60% of persons with treated hypertension. Abundant clinical trial evidence has shown that antihypertensive therapy significantly reduces the risk of vascular events, and meta‐analyses of observational and clinical trials have shown that greater reductions in blood pressure are associated with greater reductions in risk. Recent trials have also suggested that prompt control of blood pressure is beneficial in high‐risk patients with hypertension. A post hoc analysis of a trial comparing an angiotensin II receptor blocker‐based program with a calcium channel blocker‐based treatment regimen found that the blood pressure response after 1 month (regardless of the drug used) predicted the risk of vascular events and survival. Therapy with ≥2 medications given separately or as a fixed combination is more likely than monotherapy to lower blood pressure to goal in part because drugs from different classes target different mechanisms that regulate blood pressure. Moreover, the likelihood of achieving blood pressure goals is greater if the time to achieve control is shortened, and prompt control of blood pressure is more likely with multiple‐drug therapy than with monotherapy.