{"title":"Defining blood pressure goals: is it enough to manage total cardiovascular risk?","authors":"Giuseppe Mancia","doi":"10.1097/01.hjh.0000357902.93951.3a","DOIUrl":null,"url":null,"abstract":"<p><p>It is well established that lowering blood pressure (BP) in patients with hypertension is associated with cardiovascular protection. Therefore, BP goals have been defined by international hypertension guidelines (<140/90 mmHg; <130/80 mmHg for patients with type 2 diabetes). However, the relationship of BP with prognosis is complex, and controlling office BP may not be enough to optimally manage total cardiovascular risk. It is becoming clear that out-of-office BP measurements have important prognostic value. In the observational Pressioni Arteriose Monitorate E Loro Associazioni study, the risk of cardiovascular death over 11 years was progressively higher with 10-mmHg increases in office, home, or ambulatory BPs. Smooth control of 24-h BP may be of even greater importance, as the early morning BP surge, nighttime BP, and BP variability are associated with significant risk. A further consideration in managing total cardiovascular risk is the need for multiple antihypertensive agents to control BP.</p>","PeriodicalId":16074,"journal":{"name":"Journal of hypertension. Supplement : official journal of the International Society of Hypertension","volume":"27 5","pages":"S3-8"},"PeriodicalIF":0.0000,"publicationDate":"2009-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.hjh.0000357902.93951.3a","citationCount":"13","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of hypertension. Supplement : official journal of the International Society of Hypertension","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1097/01.hjh.0000357902.93951.3a","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 13
Abstract
It is well established that lowering blood pressure (BP) in patients with hypertension is associated with cardiovascular protection. Therefore, BP goals have been defined by international hypertension guidelines (<140/90 mmHg; <130/80 mmHg for patients with type 2 diabetes). However, the relationship of BP with prognosis is complex, and controlling office BP may not be enough to optimally manage total cardiovascular risk. It is becoming clear that out-of-office BP measurements have important prognostic value. In the observational Pressioni Arteriose Monitorate E Loro Associazioni study, the risk of cardiovascular death over 11 years was progressively higher with 10-mmHg increases in office, home, or ambulatory BPs. Smooth control of 24-h BP may be of even greater importance, as the early morning BP surge, nighttime BP, and BP variability are associated with significant risk. A further consideration in managing total cardiovascular risk is the need for multiple antihypertensive agents to control BP.