Journal of hypertension. Supplement : official journal of the International Society of Hypertension最新文献

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Achieving blood pressure goals: should angiotensin II receptor blockers become first-line treatment in hypertension? 实现降压目标:血管紧张素受体阻滞剂是否应成为高血压的一线治疗?
Michael Weber
{"title":"Achieving blood pressure goals: should angiotensin II receptor blockers become first-line treatment in hypertension?","authors":"Michael Weber","doi":"10.1097/01.hjh.0000357903.93951.73","DOIUrl":"https://doi.org/10.1097/01.hjh.0000357903.93951.73","url":null,"abstract":"<p><p>The benefits of blood pressure control on the risks of major cardiovascular events are well established. In clinical trials conducted in patients with mild-to-moderate hypertension, the angiotensin II receptor blocker (ARB) telmisartan has been shown to provide reduction of blood pressure throughout the 24-h dosing interval. Clinical trials have also demonstrated that ARBs are effective agents in reducing the risk of cardiovascular mortality, stroke, heart failure and new-onset atrial fibrillation. Recently, the ONgoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial (ONTARGET) study established that telmisartan reduces morbidity and mortality in a broad cross-section of patients at high risk for heart and vascular events, to an extent similar to that of the angiotensin-converting enzyme inhibitor ramipril. In addition, ONTARGET demonstrated that telmisartan is somewhat better tolerated than ramipril. Attributes such as effective blood pressure lowering, tolerability and convincing outcomes data mean that ARBs satisfy the requirements for first-line antihypertensive agents.</p>","PeriodicalId":16074,"journal":{"name":"Journal of hypertension. Supplement : official journal of the International Society of Hypertension","volume":"27 5","pages":"S9-14"},"PeriodicalIF":0.0,"publicationDate":"2009-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.hjh.0000357903.93951.73","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28294746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 9
Effects of angiotensin II receptor blockers on diabetic nephropathy. 血管紧张素受体阻滞剂对糖尿病肾病的影响。
Rigas Kalaitzidis, George L Bakris
{"title":"Effects of angiotensin II receptor blockers on diabetic nephropathy.","authors":"Rigas Kalaitzidis,&nbsp;George L Bakris","doi":"10.1097/01.hjh.0000357904.71080.7d","DOIUrl":"https://doi.org/10.1097/01.hjh.0000357904.71080.7d","url":null,"abstract":"<p><p>Impaired kidney function increases the risk of cardiovascular morbidity and mortality. Coexistence of hypertension and type 2 diabetes increases the risk of kidney damage, hypertension being an independent risk factor for kidney disease progression. Angiotensin II, through its inflammatory, proliferative, and thrombotic effects, adversely affects renal perfusion and increases oxidative stress, thus playing a pivotal role in kidney disease progression. Angiotensin II receptor blockers (ARBs) and angiotensin-converting enzyme (ACE) inhibitors improve markers of kidney disease and slow kidney disease progression in diabetic and nondiabetic patients; this kidney protection may be in addition to their antihypertensive activity in those with advanced proteinuric nephropathy. Key beneficial effects of ARBs and ACE inhibitors throughout the kidney disease continuum are primarily explained by blood pressure lowering effects and partially by their direct blockade of angiotensin II. Recent studies have shown that telmisartan, an ARB with high lipophilicity and the longest half-life compared with other ARBs, provides benefits on markers of cardiovascular risk, that is, microalbuminuria and slowing of early-stage nephropathy.</p>","PeriodicalId":16074,"journal":{"name":"Journal of hypertension. Supplement : official journal of the International Society of Hypertension","volume":"27 5","pages":"S15-21"},"PeriodicalIF":0.0,"publicationDate":"2009-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.hjh.0000357904.71080.7d","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28294741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 31
Clinical evidence from ONTARGET: the value of an angiotensin II receptor blocker and an angiotensin-converting enzyme inhibitor. 来自ONTARGET的临床证据:血管紧张素II受体阻滞剂和血管紧张素转换酶抑制剂的价值。
Peter Sleight
{"title":"Clinical evidence from ONTARGET: the value of an angiotensin II receptor blocker and an angiotensin-converting enzyme inhibitor.","authors":"Peter Sleight","doi":"10.1097/01.hjh.0000357905.78704.9a","DOIUrl":"https://doi.org/10.1097/01.hjh.0000357905.78704.9a","url":null,"abstract":"<p><p>The Heart Outcomes Prevention Evaluation study established the angiotensin-converting enzyme inhibitor ramipril, versus placebo, for prevention of cardiovascular events in high-risk patients. The ONgoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial (ONTARGET) was later conducted in similar high-risk patients using multifactorial treatment to control hypertension, platelet aggregation, and dyslipidemia, while comparing ramipril, telmisartan, or their combination, without placebo. In ONTARGET, the first angiotensin II receptor blocker-based study to be performed in a broader population of patients without congestive heart failure and/or left ventricular hypertrophy/dysfunction, telmisartan provided cardiovascular protection that was noninferior to ramipril. However, greater blockade of the renin-angiotensin system, using their combination, was not superior to ramipril alone. Telmisartan was better tolerated than ramipril in this high-risk population: notably, the incidence of cough and angioedema was significantly lower with telmisartan alone. Thus, telmisartan provides comparable efficacy to ramipril with less adverse events, which may encourage patient compliance.</p>","PeriodicalId":16074,"journal":{"name":"Journal of hypertension. Supplement : official journal of the International Society of Hypertension","volume":"27 5","pages":"S23-9"},"PeriodicalIF":0.0,"publicationDate":"2009-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.hjh.0000357905.78704.9a","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28294742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 15
Defining blood pressure goals: is it enough to manage total cardiovascular risk? 确定血压目标:是否足以控制心血管总风险?
Giuseppe Mancia
{"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":"https://doi.org/10.1097/01.hjh.0000357902.93951.3a","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":0.0,"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":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28294743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 13
Cardiovascular protection: a breakthrough for high-risk patients? 心血管保护:高危患者的突破?
Roberto Ferrari
{"title":"Cardiovascular protection: a breakthrough for high-risk patients?","authors":"Roberto Ferrari","doi":"10.1097/01.hjh.0000357907.68402.99","DOIUrl":"https://doi.org/10.1097/01.hjh.0000357907.68402.99","url":null,"abstract":"<p><p>Angiotensin II has diverse effects on cardiovascular structure and function, and hence drugs that inhibit the formation or activity of this peptide have attained a central position in the prevention of morbidity and mortality from cardiovascular causes. The recent ONgoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial (ONTARGET) has shown that, in patients with vascular disease or patients with diabetes who were at high risk of cardiovascular events, the angiotensin II receptor blocker telmisartan is noninferior to the angiotensin-converting enzyme inhibitor ramipril in preventing such events, despite the ONTARGET patients receiving better background preventive therapy than those enrolled in the earlier Heart Outcomes Prevention Evaluation (HOPE) study. In addition, telmisartan offers superior tolerability to that of ramipril. Moreover, the finding in this study that combination therapy with telmisartan and ramipril produced no further reduction in cardiovascular events than either drug alone, despite producing greater reductions in blood pressure, highlights the potential importance of endothelial effects of renin-angiotensin system blockade in cardiovascular protection.</p>","PeriodicalId":16074,"journal":{"name":"Journal of hypertension. Supplement : official journal of the International Society of Hypertension","volume":"27 5","pages":"S37-40"},"PeriodicalIF":0.0,"publicationDate":"2009-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.hjh.0000357907.68402.99","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28294745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Introduction: Reducing cardiovascular risk: ONTARGET--a new standard in cardiovascular protection. 前言:降低心血管风险:ONTARGET——心血管保护的新标准。
Giuseppe Mancia, Thomas Unger, Alberto Zanchetti
{"title":"Introduction: Reducing cardiovascular risk: ONTARGET--a new standard in cardiovascular protection.","authors":"Giuseppe Mancia,&nbsp;Thomas Unger,&nbsp;Alberto Zanchetti","doi":"10.1097/01.hjh.0000357901.86327.d8","DOIUrl":"https://doi.org/10.1097/01.hjh.0000357901.86327.d8","url":null,"abstract":"The papers that comprise this supplement were presented at two satellite symposia held in Berlin on the 17 and 18 June 2008 at the joint congress for the 18 Scientific Meeting of the European Society of Hypertension and the 22nd Scientific Meeting of the International Society of Hypertension. The two symposia were sponsored by Boehringer Ingelheim and were entitled ‘Reducing Cardiovascular Risk: New Insights From ONTARGET, and ‘ONTARGET: New Standard in Cardio & Vascular Protection’. The aim of the lectures in these symposia was to provide a wider perspective of the landmark ONgoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial (ONTARGET) Programme.","PeriodicalId":16074,"journal":{"name":"Journal of hypertension. Supplement : official journal of the International Society of Hypertension","volume":"27 5","pages":"S1"},"PeriodicalIF":0.0,"publicationDate":"2009-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.hjh.0000357901.86327.d8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28294740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Preventing stroke: the PRoFESS, ONTARGET, and TRANSCEND trial programs. 预防中风:PRoFESS、ONTARGET和TRANSCEND试验项目。
Hans-Christoph Diener
{"title":"Preventing stroke: the PRoFESS, ONTARGET, and TRANSCEND trial programs.","authors":"Hans-Christoph Diener","doi":"10.1097/01.hjh.0000357906.60778.7f","DOIUrl":"https://doi.org/10.1097/01.hjh.0000357906.60778.7f","url":null,"abstract":"<p><p>Renin-angiotensin system blockers have been shown to reduce stroke risk, partly independent of their blood pressure-lowering effect. The PReventiOn regimen For Effectively avoiding Second Strokes (PRoFESS) trial, ONgoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial (ONTARGET) and Telmisartan Randomized AssessmeNt Study in aCE-iNtolerant subjects with cardiovascular Disease (TRANSCEND) recently showed potential benefits of the angiotensin II receptor blocker, telmisartan, in reducing secondary strokes. In PRoFESS, 20 332 ischemic stroke patients were randomized to telmisartan 80 mg versus placebo and to two antiplatelets in a 2 x 2 factorial design. After a mean exposure of 2 years, telmisartan showed a nonsignificant lower rate of recurrent stroke versus placebo [880 versus 934; hazard ratio 0.95; 95% confidence interval (CI) 0.86-1.04]. In a post-hoc analysis, from 6 months, telmisartan significantly reduced the number of strokes versus placebo (533 versus 608; hazard ratio 0.88; 95% CI 0.78-0.99; P = 0.042). In the stroke subgroup of ONTARGET, telmisartan 80 mg showed a trend toward reducing recurrent stroke versus ramipril 10 mg (hazard ratio 0.91; 95% CI 0.79-1.05). In the TRANSCEND study, 5926 patients who were intolerant to angiotensin-converting enzyme inhibitors were treated with 80 mg telmisartan or placebo. In a combined analysis of PRoFESS and TRANSCEND, the incidence of the composite of stroke, myocardial infarction, or vascular death was 12.8% for telmisartan versus 13.8% for placebo (hazard ratio 0.91; 95% CI 0.85-0.98; P = 0.013).</p>","PeriodicalId":16074,"journal":{"name":"Journal of hypertension. Supplement : official journal of the International Society of Hypertension","volume":"27 5","pages":"S31-6"},"PeriodicalIF":0.0,"publicationDate":"2009-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.hjh.0000357906.60778.7f","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28294744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 24
Dual blockade versus single blockade of the renin-angiotensin system in the light of ONTARGET. 根据ONTARGET,肾素-血管紧张素系统的双重阻断与单一阻断。
Isabella Sudano, Georg Noll
{"title":"Dual blockade versus single blockade of the renin-angiotensin system in the light of ONTARGET.","authors":"Isabella Sudano,&nbsp;Georg Noll","doi":"10.1097/01.hjh.0000354513.52203.a4","DOIUrl":"https://doi.org/10.1097/01.hjh.0000354513.52203.a4","url":null,"abstract":"<p><p>Angiotensin II plays an important role in the cardiovascular continuum starting with risk factors and progressing to atherosclerosis, target organ damage, and ultimately to heart failure, stroke, or death. Inhibiting the renin-angiotensin-aldosterone system (RAAS) represents a cornerstone for the treatment of hypertension and heart failure. In patients with heart failure, the single RAAS blockade with angiotensin-converting enzyme (ACE) inhibitors have been shown to reduce morbidity and mortality, increase life expectancy, and preserve the renal function. AT1 receptor blockers (ARBs) are equally effective in reducing mortality and morbidity in patients with impaired left ventricular function. The combination of ACE inhibitors with ARBs leads to an additive blood pressure lowering effect, better reduction in proteinuria, and to additive benefits in heart failure and left ventricular hypertrophy. But combination therapy is also associated with more side effects. Further investigations evaluating the effect of dual RAAS blockade on fatal and nonfatal cardiovascular events are needed.</p>","PeriodicalId":16074,"journal":{"name":"Journal of hypertension. Supplement : official journal of the International Society of Hypertension","volume":"27 2","pages":"S11-4"},"PeriodicalIF":0.0,"publicationDate":"2009-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.hjh.0000354513.52203.a4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28216851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 5
Practical aspects of treatment discontinuation and adherence. 停止治疗和坚持治疗的实际方面。
Gianfranco Parati, Grzegorz Bilo
{"title":"Practical aspects of treatment discontinuation and adherence.","authors":"Gianfranco Parati,&nbsp;Grzegorz Bilo","doi":"10.1097/01.hjh.0000354515.36956.67","DOIUrl":"https://doi.org/10.1097/01.hjh.0000354515.36956.67","url":null,"abstract":"<p><p>Hypertension control in populations, although improving, remains far from satisfactory, even though effective and inexpensive therapies are available. Among many factors responsible for this situation, poor adherence to treatment appears to be particularly important. Unfortunately, even if its causes have been quite well defined, this problem is still far from being solved in clinical practice. The present paper discusses the key issues related to treatment adherence, and discontinuation in hypertension, in the light of recent evidence coming from the ONgoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial (ONTARGET) and Telmisartan Randomized AssessmeNt Study in ACE iNtolerant subjects with cardiovascular Disease trial (TRANSCEND).</p>","PeriodicalId":16074,"journal":{"name":"Journal of hypertension. Supplement : official journal of the International Society of Hypertension","volume":"27 2","pages":"S18-21"},"PeriodicalIF":0.0,"publicationDate":"2009-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.hjh.0000354515.36956.67","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28216853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
Arterial hypertension greatly contributes to the development and evolution of cardiovascular and renal diseases. Editorial. 动脉高血压对心血管和肾脏疾病的发展和演变有很大的促进作用。社论。
Luis M Ruilope
{"title":"Arterial hypertension greatly contributes to the development and evolution of cardiovascular and renal diseases. Editorial.","authors":"Luis M Ruilope","doi":"10.1097/01.hjh.0000356765.78765.7f","DOIUrl":"https://doi.org/10.1097/01.hjh.0000356765.78765.7f","url":null,"abstract":"","PeriodicalId":16074,"journal":{"name":"Journal of hypertension. Supplement : official journal of the International Society of Hypertension","volume":"27 3","pages":"S1"},"PeriodicalIF":0.0,"publicationDate":"2009-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.hjh.0000356765.78765.7f","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28228245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
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