Acetylsalicylic acid ( ASA ) did not reduce stroke or ' all cardiovascular events ' compared to placebo in primary prevention patients with elevated blood pressure and no prior cardiovascular disease .
Antiplatelet therapy with ASA for primary prevention in patients with elevated blood pressure provides a benefit , reduction in myocardial infa rct ion , which is negated by a harm of similar magnitude , increase in major haemorrhage .
The benefit of antiplatelet therapy for secondary prevention in patients with elevated blood pressure is many times greater than the harm .
Benefit has not been demonstrated for warfarin therapy alone or in combination with aspirin in patients with elevated blood pressure .
BACKGROUND Elevated systemic blood pressure results in high intravascular pressure but the main complications , coronary heart disease ( CHD ) , ischaemic strokes and peripheral vascular disease ( PVD ) , are related to thrombosis rather than haemorrhage .
Some complications related to elevated blood pressure , heart failure or atrial fibrillation , are themselves associated with stroke and thromboembolism .
Therefore it is important to investigate if antithrombotic therapy may be useful in preventing thrombosis-related complications in patients with elevated blood pressure .
OBJECTIVES To conduct a systematic review of the role of antiplatelet therapy and anticoagulation in patients with high blood pressure , including those with elevations in both systolic and diastolic blood pressure , isolated elevations of either systolic or diastolic blood pressure , to address the following hypotheses : ( i ) antiplatelet agents reduce total deaths and /or major thrombotic events when compared to placebo or other active treatment ; and ( ii ) oral anticoagulants reduce total deaths and /or major thromboembolic events when compared to placebo or other active treatment .
Ticlopidine , clopidogrel and newer antiplatelet agents such as prasugrel and ticagrelor have not been sufficiently evaluated in patients with high blood pressure .
Haemodynamic changes induced by the correction of anaemia by erythropoietin: role of antiplatelet therapy.
BACKGROUND In a retrospective study , antiplatelet therapy has been shown to be associated with a decreased incidence of erythropoietin-induced hypertension . In order to ascertain the role of antiplatelet drugs in the haemodynamic response to the correction of anaemia by rHuEpo , 18 patients on chronic haemodialysis who started rHuEpo therapy  were prospect ively studied . METHODS The subjects were r and omly assigned to receive or not , one of the following antiplatelet drugs : ditazole ( 3 patients ) , ticlopidine ( 3 patients ) or aspirin plus dipyridamole ( 3 patients ) . Cardiac index ( CI ) by echo-Doppler , total peripheral resistance ( TPR ) and mean arterial pressure ( MAP ) were determined at baseline 10 and 20 weeks following the initiation of rHuEpo therapy . rHuEpo therapy was administered subcutaneously at the same dose ( 40 U/kg thrice weekly ) during the first 10 weeks . Ten uraemic patients on haemodialysis who had never received rHuEpo therapy served as the control group . RESULTS One patient in the group without antiplatelet drugs discontinued the study due to the development of severe hypertension after 12 weeks on rHuEpo therapy . There were no significant differences in the haemodynamic parameters at baseline . At 10 weeks , MAP was higher in patients without than with antiplatelet drugs or controls untreated with rHuEpo ( 128.5 + /- 28 versus 100.6 + /- 13.5 versus 98.7 + /- 14 mmHg respectively , P = 0.0047 ) , TPR was also higher in patients without antiplatelet drugs than in the 2 other groups ( 1919 + /- 433 versus 1576 + /- 359 versus 1418 + /- 324 din.seg.cm-5m2 respectively , P = 0.0231 ) , but CI did not differ among the three groups . At 20 weeks , MAP was still higher in patients without antiplatelet drugs than in patients with antiplatelet drugs or controls not on rHuEpo therapy respectively ( 112.9 + /- 24.6 versus 91.0 + /- 9.0 versus 101.7 + /- 14.1 mmHg respectively , P = 0.075 ) , but at this stage TPR and Cl did not differ among the three groups . CONCLUSIONS These data reinforce the previous observation that antiplatelet therapy may prevent the development of rHuEpo-induced hypertension
Acetylsalicylic acid ( ASA ) did not reduce stroke or ' all cardiovascular events ' compared to placebo in primary prevention patients with elevated blood pressure and no prior cardiovascular disease .
Antiplatelet therapy with ASA for primary prevention in patients with elevated blood pressure provides a benefit , reduction in myocardial infa rct ion , which is negated by a harm of similar magnitude , increase in major haemorrhage .
The benefit of antiplatelet therapy for secondary prevention in patients with elevated blood pressure is many times greater than the harm .
Benefit has not been demonstrated for warfarin therapy alone or in combination with aspirin in patients with elevated blood pressure .
BACKGROUND Elevated systemic blood pressure results in high intravascular pressure but the main complications , coronary heart disease ( CHD ) , ischaemic strokes and peripheral vascular disease ( PVD ) , are related to thrombosis rather than haemorrhage .
Some complications related to elevated blood pressure , heart failure or atrial fibrillation , are themselves associated with stroke and thromboembolism .
Therefore it is important to investigate if antithrombotic therapy may be useful in preventing thrombosis-related complications in patients with elevated blood pressure .
OBJECTIVES To conduct a systematic review of the role of antiplatelet therapy and anticoagulation in patients with high blood pressure , including those with elevations in both systolic and diastolic blood pressure , isolated elevations of either systolic or diastolic blood pressure , to address the following hypotheses : ( i ) antiplatelet agents reduce total deaths and /or major thrombotic events when compared to placebo or other active treatment ; and ( ii ) oral anticoagulants reduce total deaths and /or major thromboembolic events when compared to placebo or other active treatment .
Ticlopidine , clopidogrel and newer antiplatelet agents such as prasugrel and ticagrelor have not been sufficiently evaluated in patients with high blood pressure .