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Pros and Cons of Intensive Systolic Blood Pressure Lowering

  • Mechanisms of Hypertension (M Weir, Section Editor)
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Abstract

Purpose of Review

The Systolic Blood Pressure Intervention Trial demonstrated significant decreases in cardiovascular events and total mortality with intensive systolic blood pressure lowering in adults with high cardiovascular risk in the absence of diabetes but benefits were accompanied by increased risk of adverse events.

Recent Findings

Over 100,000 deaths and 46,000 cases of heart failure may be prevented annually if intensive systolic blood pressure lowering is implemented in 17 million US adults who are age 50 years and older, and have high cardiovascular risk in the absence of diabetes and meet eligibility for the Systolic Blood Pressure Intervention Trial. However, the benefits of intensive SBP lowering will be accompanied by an excess of 43,000 cases of electrolyte abnormalities and 88,000 cases of acute kidney injury.

Summary

Physicians should consider implementation of intensive systolic blood pressure lowering in appropriate patients who understand the risks and benefits of this intervention.

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References

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Authors and Affiliations

  1. Department of Public Health Sciences, Loyola University Chicago, 2160 S. First Avenue, Maywood, IL, 60153, USA

    Holly Kramer & Richard Cooper

  2. Medicine, Division of Nephrology and Hypertension, Loyola University Chicago, Maywood, IL, USA

    Holly Kramer

  3. Hines VA Medical Center, Hines, IL, USA

    Holly Kramer

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  1. Holly Kramer
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Correspondence to Holly Kramer.

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This article is part of the Topical Collection on Mechanisms of Hypertension

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Kramer, H., Cooper, R. Pros and Cons of Intensive Systolic Blood Pressure Lowering. Curr Hypertens Rep 20, 16 (2018). https://doi.org/10.1007/s11906-018-0806-x

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