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 .
Enhanced blood pressure response to cyclooxygenase inhibition in salt-sensitive human essential hypertension.
To evaluate the influence of salt sensitivity on the blood pressure response to oral indomethacin treatment , we studied 35 hospitalized essential hypertensive patients ( 24 men and 11 women , aged from 40 to 55 years ) . During a normal NaCl intake ( 120 mmol Na+ per day ) , patients were assigned to receive in a r and omized double-blind fashion either 200 mg indomethacin ( 25 patients ) or placebo ( 10 patients ) for 5 days . Two weeks after the interruption of indomethacin treatment , during which the normal NaCl intake was continued , salt sensitivity was assessed by giving each patient a high ( 220 mmol Na+ per day for 10 days ) and then a low ( 20 mmol Na+ per day for 10 days ) NaCl diet . Blood pressure changes were evaluated , and the measurement taken at the end of the 2 weeks under normal sodium intake was considered baseline blood pressure . Patients were classified as salt sensitive when a diastolic blood pressure change of 10 mm Hg or more occurred after both low and high periods of sodium intake . In salt-resistant patients treated with indomethacin ( n = 12 , nine men and three women , mean age 50.5 + /- 3.7 years ) , neither blood pressure ( systolic blood pressure from 150.8 + /- 11.2 to 154.6 + /- 9.3 mm Hg , NS ; diastolic blood pressure from 99.3 + /- 2.1 to 101.1 + /- 4.4 mm Hg , NS ) nor the urinary Na+ excretion ( from 108.1 + /- 20.9 to 97.9 + /- 9.1 mmol/24 hr , NS ) was significantly affected by the drug . ( 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 .