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 .
The impact of ibuprofen on the efficacy of antihypertensive treatment with hydrochlorothiazide in elderly persons.
BACKGROUND Nonsteroidal antiinflammatory drugs ( NSAIDs ) may alter blood pressure through their inhibitory effects on prostagl and in bio synthesis . Such potential hypertensive effects of NSAIDs have not been adequately examined in the elderly , who are the largest group of NSAID users . METHODS We performed a r and omized , double-blind , two-period crossover trial of ibuprofen ( 1800 mg per day ) vs placebo treatment in patients older than 60 years of age with hypertension controlled with hydrochlorothiazide .  While continuing their usual thiazide dosage , subjects were r and omized to a 4-week treatment period ( ibuprofen or placebo ) followed by a 2-week placebo wash-out period and a second 4-week treatment period with the alternative therapy .  Supine and st and ing systolic and diastolic blood pressures were measured weekly . RESULTS Of 25 r and omized subjects , 22 completed the study protocol ( mean age = 73 + /- 6.7 years ) .  Supine systolic blood pressure and st and ing systolic blood pressure were increased significantly with ibuprofen treatment , compared with placebo .  Mean supine systolic blood pressures were 143.8 + /- 21.0 and 139.6 + /- 15.9 mmHg on ibuprofen and placebo , respectively ( p = .004 ) . Mean st and ing systolic blood pressures were 148.1 + /- 19.9 and 143.4 + /- 17.9 mmHg on ibuprofen and placebo , respectively ( p = .002 ) . CONCLUSION We conclude that 1800 mg per day of ibuprofen does induce a significant increase in systolic blood pressure in older hypertensive patients treated with hydrochlorothiazide . NSAID therapy may negatively impact the control of hypertension in elderly patients
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 .