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 .
Assessment of blood pressure during treatment with naproxen or ibuprofen in hypertensive patients treated with hydrochlorothiazide.
This study determined the effect of nonsteroidal anti-inflammatory drug ( NSAID ) administration on blood pressure in hypertensive patients taking hydrochlorothiazide ( HCTZ ) . Ninety-seven patients with mild essential hypertension and a musculoskeletal indication for NSAID use were studied in a three-phase , multi-center , double-blind , r and omized , parallel study based in 15 academic and community clinics . Patients served as their own controls . Patients with stable hypertension , not taking antihypertensive or NSAID medications , were treated with HCTZ 50 mg/day . After 4 to 5 weeks of treatment and documented stable blood pressure , naproxen 375 mg twice a day or ibuprofen 800 mg three times a day was added . Blood pressure was measured at 2 and 4 weeks of NSAID therapy . The average diastolic blood pressure was 97.5 + /- 2.4 mm Hg and the average of the mean arterial pressure ( MAP ) was 116.8 + /- 6.04 before treatment with HCTZ . Hydrochlorothiazide treatment decreased diastolic blood pressure to 83.1 + /- 5.6 mm Hg , and MAP to 101.1 + /- 6.5 mm Hg . With naproxen or ibuprofen treatments , mean diastolic blood pressure increased less than 3 mm Hg . At 2 weeks , ibuprofen increased diastolic blood pressure by 2.6 mm Hg ( P = .004 ) and naproxen increased diastolic blood pressure 0.7 mm Hg ( P = .40 ) . Both ibuprofen and naproxen significantly increased diastolic pressure at 4 weeks ( 2.1 mm Hg , P = .042 ; and 1.8 mm Hg , P = .043 , respectively ) . There was no correlation between the pre-NSAID blood pressure and the magnitude of change after 2 or 4 weeks of treatment . Changes in MAP reflected a pattern similar to diastolic pressure . ( ABSTRACT TRUNCATED AT 250 WORDS
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 .