Science in Perspective –  Hypertension
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Science in Perspective – Hypertension

September 29, 2019

Among the important revisions
in the 2013 ESC/ESH guidelines on arterial
hypertension is the simplification of blood pressure
targets Whereas before there was different target,
140 over 90 and also a target of 130 over 80 particularly in
high-risk patients, now we have considered that there was not enough evidence for the lower target in
most cases So now the systolic blood pressure
target is 140 mmHg with few exceptions
For diastolic blood pressure the universal target is 90 mmHg except for diabetes patients
where the target is 85 mmHg The idea is to start, if possible,
with combination therapy In which indication?
When there is either high-level of blood pressure of high-rik, but please start which
combination therapy each time you think that in any case
you will use 2 or 3 drugs and then continue with
combination therapy because the sooner you lower blood pressure,
the better it is for the future The purpose of this meta-analysis
was to calculate the effect in terms of
cardiovascular mortality and also coronary events of RAAS inhibitors strategies, detailing
their respective effect of ACEs and ARBs compared to non RAAS
inhibitors strategies in hypertensive populations
We focused our analysis in terms of coronary events
and what we found is that we had a significant effect of ACEs based strategies in terms of
coronary events, and a beneficial effect,
where as for AARBs we have a tendency, a trend, to a harmful effect with a virtual negative number needed to
treat to prevent one coronary event The message from the 3 year Symplicity HTN-1
is that we have demonstrated that the short term
benefits in terms of blood pressure lowering can
be extended now to the full 3 years of follow-up and moreover, that benefit on blood
pressure is achieved with a very good safety profile ESC Congress 365 is your free access to ESC Congress content all year long.

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