Acetylsalicylic acid ( ASA ) did not reduce stroke or ‘ all cardiovascular events ’ compared to placebo in primary prevention patients with elevated BP and no prior cardiovascular disease .
To conclude for primary prevention in patients with elevated BP , antiplatelet therapy with ASA can not be recommended since the magnitude of benefit , a reduction in myocardial infa rct ion , is negated by a harm of similar magnitude , an increase in major haemorrhage .
Although elevated systemic blood pressure ( BP ) results in high intravascular pressure , the main complications of hypertension are related to thrombosis rather than haemorrhage .
It therefore seemed plausible that use of antithrombotic therapy may be useful in preventing thrombosis-related complications of elevated BP .
The objectives were to conduct a systematic review of the role of antiplatelet therapy and anticoagulation in patients with BP , 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 .
Comparative effects of nabumetone, sulindac, and ibuprofen on renal function.
OBJECTIVE Nonsteroidal antiinflammatory drugs ( NSAID ) have been associated with hemodynamically mediated acute renal failure .  There appear to be differences among NSAID in producing this effect . We compare renal effects of ibuprofen , sulindac , and nabumetone . METHODS Seventeen women over age 56 receiving hydrochlorothiazide and fosinopril for hypertension who had osteoarthritis requiring NSAID received 3 different NSAID to evaluate potential varying renal effects . In an investigator blinded r and omized study , patients received nabumetone , sulindac , or ibuprofen for 1 month with intervening 2 week control periods . After each period renal function was assessed by inulin and para-aminohippurate clearances and urinary prostagl and ins were measured . RESULTS No overall statistical differences among the NSAID were observed . However , there were clinical ly meaningful differences during ibuprofen therapy : 4 patients developed a clinical ly significant decrease in renal function ; during sulindac therapy one of these also developed a clinical ly significant decrease in renal function . During nabumetone there were 0 episodes of clinical ly significant decrease in renal function . Using Gomez equations , glomerular hydrostatic pressure and afferent and efferent arteriolar resistances were estimated . None changed overall during any intervention . However , the 4 patients who developed decreased renal function while taking ibuprofen were analyzed separately . Glomerular hydrostatic pressure decreased 15 % ; afferent arteriolar resistance increased 85 % . These changes were associated with marked decreases in vasodilatory prostagl and ins compared to patients receiving ibuprofen who did not develop decreases in renal function . CONCLUSION There are differences in effect on renal function among NSAID . These can be correlated with specific alterations in suppression of the cyclooxygenase system cascade and related to changes in the hemodynamic control of glomerular filtration
Acetylsalicylic acid ( ASA ) did not reduce stroke or ‘ all cardiovascular events ’ compared to placebo in primary prevention patients with elevated BP and no prior cardiovascular disease .
To conclude for primary prevention in patients with elevated BP , antiplatelet therapy with ASA can not be recommended since the magnitude of benefit , a reduction in myocardial infa rct ion , is negated by a harm of similar magnitude , an increase in major haemorrhage .
Although elevated systemic blood pressure ( BP ) results in high intravascular pressure , the main complications of hypertension are related to thrombosis rather than haemorrhage .
It therefore seemed plausible that use of antithrombotic therapy may be useful in preventing thrombosis-related complications of elevated BP .
The objectives were to conduct a systematic review of the role of antiplatelet therapy and anticoagulation in patients with BP , 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 .