Getting to Lower Systolic Blood Pressure: Beyond Antihypertensive Therapy
Authors: Nadia A. Khan
Journal: Annals of Internal Medicine (2016)

Ideas and Opinions1 November 2016Getting to Lower Systolic Blood Pressure: Beyond Antihypertensive TherapyNadia A. Khan, MD, MScNadia A. Khan, MD, MScFrom University of British Columbia, Vancouver, British Columbia, Canada.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M16-1421 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail In response to SPRINT (Systolic Blood Pressure Intervention Trial), Hypertension Canada–Canadian Hypertension Education Program guidelines recommend that all patients with hypertension and high cardiovascular risk keep their systolic blood pressure (SBP) at 120 mm Hg or lower (1, 2). As more guidelines are updated, other organizations likely will advocate for more-intensive SBP targets in selected, high-risk patients. Given that the current SBP treatment goal of less than 140 mm Hg is already inadequately met, many clinicians will struggle with how to achieve the newer, more-intensive target in appropriate patients.SPRINT randomly assigned 9361 patients with hypertension to an intensive SBP ...References1. Leung AA, Nerenberg K, Daskalopoulou SS, McBrien K, Zarnke KB, Dasgupta K, et al; CHEP Guidelines Task Force. Hypertension Canada's 2016 Canadian Hypertension Education Program guidelines for blood pressure measurement, diagnosis, assessment of risk, prevention, and treatment of hypertension. Can J Cardiol. 2016;32:569-88. [PMID: 27118291] doi:10.1016/j.cjca.2016.02.066 CrossrefMedlineGoogle Scholar2. Wright JT, Williamson JD, Whelton PK, Snyder JK, Sink KM, Rocco MV, et al; SPRINT Research Group. A randomized trial of intensive versus standard blood-pressure control. N Engl J Med. 2015;373:2103-16. [PMID: 26551272] doi:10.1056/NEJMoa1511939 CrossrefMedlineGoogle Scholar3. Myers MG, Godwin M. 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Lonn EM, Bosch J, López-Jaramillo P, Zhu J, Liu L, Pais P, et al; HOPE-3 Investigators. Blood-pressure lowering in intermediate-risk persons without cardiovascular disease. N Engl J Med. 2016;374:2009-20. [PMID: 27041480] doi:10.1056/NEJMoa1600175 CrossrefMedlineGoogle Scholar8. Bruckert E, Bonnelye G, Thomas-Delecourt F, André L, Delaage PH. Assessment of cardiovascular risk in primary care patients in France. Arch Cardiovasc Dis. 2011;104:381-7. [PMID: 21798470] doi:10.1016/j.acvd.2011.04.007 CrossrefMedlineGoogle Scholar9. Williamson JD, Supiano MA, Applegate WB, Berlowitz DR, Campbell RC, Chertow GM, et al; SPRINT Research Group. Intensive vs standard blood pressure control and cardiovascular disease outcomes in adults aged ≥75 years: a randomized clinical trial. JAMA. 2016;315:2673-82. [PMID: 27195814] doi:10.1001/jama.2016.7050 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From University of British Columbia, Vancouver, British Columbia, Canada.Disclosures: The author has disclosed no conflicts of interest. The form can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M16-1421.Corresponding Author: Nadia A. Khan, University of British Columbia, Center for Health Evaluation and Outcomes Sciences, 570.4B, 1081 Burrard Street, Vancouver, British Columbia V6Z 1Y6, Canada; e-mail, [email protected]com.Author Contributions: Conception and design: N.A. Khan.Analysis and interpretation of the data: N.A. Khan.Drafting of the article: N. Khan.Critical revision for important intellectual content: N. Khan.Final approval of the article: N. Khan.This article was published at www.annals.org on 16 August 2016. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 November 2016Volume 165, Issue 9Page: 661-662KeywordsAntihypertensive drug therapyBlood pressureCardiovascular disease riskCardiovascular diseasesElderlyHypertensionHypotensionMortalityMyocardial infarctionSystolic pressure ePublished: 16 August 2016 Issue Published: 1 November 2016 Copyright & PermissionsCopyright © 2016 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...