Page 7 - hypertension_newsletter7

REFLECTIONS
Hypertension
Hypertension Global Newsletter #7 2024

The authors conclude with 10 key implications for clinical practice. Hypertension

1 It is important to use proper techniques with a recently calibrated device to measure BP

2 It is important to detect and correct reversible causes of elevated inpatient BP
3 In the ED setting, for asymptomatic elevated BP or asymptomatic markedly elevated BP, evidence supports avoiding intensifying
hypertension medications, with a preference toward restarting home medications and planning for close outpatient follow-up care

4 Further research is needed to better define optimal inpatient BP measurement methods across different settings
5 Hypertensive emergencies require immediate and acute treatment, usually with parenteral medications and often in the ICU setting

6 Elevated BP in the hospital without new or worsening target-organ damage may be best served by accurate remeasurement
and attention to contributing circumstantial factors

7 Working with hospital administration to ensure regular validation of BP measurement devices may reduce erroneous elevated
BP readings

8 The threshold to initiate or intensify antihypertensive medications in response to asymptomatic elevated inpatient BP should be high
9 Use of intravenous antihypertensives is not supported by the evidence in the absence of hypertensive emergency
10 Research is needed to determine the ideal inpatient candidate for intensification of the antihypertensive medication in response
to asymptomatic elevated inpatient BP readings

CLICK HERE
FOR THE LINK TO FULL ARTICLE

CLICK HERE
TO VIEW A DISCUSSION FROM TWO
OF THE AUTHORS OF THE SCIENTIFIC
STATEMENT, DR. ADAM PRESS AND
DR. TARA CHANG (13:40).

TARGETS AND TREATMENT

Optimal antihypertensive systolic blood pressure: A systematic review and meta-analysis.

Whelton PK, et al. Hypertension. 2024 Sep 12. doi: 10.1161/HYPERTENSIONAHA.124.23597. Online ahead of print.

There is no universal agreement on the optimal intensity of antihypertensive treatment with different BP treatment targets
recommended by different guidelines. This systematic review and meta-analysis aimed to assess randomised controlled trials
(RCTs) that compared SBP <130 mmHg with higher targets and an SBP <120 with <140 mmHg. It also looked at the effects of
these treatment differences on major CVD events, all-cause mortality, and AEs.

Seven trials, including 72,138 participants, were included in the meta-analysis. The mean age of the participants ranged from 62 to
68 years, and the proportion of women ranged from 31% to 61%. The trials were conducted in various patient populations, and six of

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