Skip to main content
SpringerLink
Log in

Preventive Lessons from Hypertension and Myocardial Infarction: Treating Asymptomatic Individuals to Lower the Risk for Subsequent Cardiovascular Events

  • Chapter
  • First Online:
Blood Pressure and Arterial Wall Mechanics in Cardiovascular Diseases

  • 1946 Accesses

Abstract

The establishment of hypertension as a risk factor for premature fatal and nonfatal cardiovascular diseases by epidemiological studies was the first step in developing a management strategy to improve prognosis. The demonstration in randomized, placebo- controlled trials that chronic antihypertensive therapy could reduce this risk provided the impetus for an ongoing educational program to motivate both physicians and patients to use pharmacologic agents to treat this asymptomatic condition in order to prevent future adverse cardiovascular events. The parallelisms between the concepts, surrogate outcomes, and more definitive randomized placebo-controlled trials addressing clinical outcome for the use of angiotensin-converting enzyme (ACE) inhibitors in asymptomatic individuals with left ventricular dysfunction are presented. In both cases, the combination of definitive outcomes and safety data coupled with a supportive educational program are needed for physicians and patients to accept and continue lifelong therapy for asymptomatic conditions.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 199.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Heidenreich PA, Trogdon JG, Khavjou OA, Butler J, Dracup K, Ezekowitz MD, et al. Forecasting the future of cardiovascular disease in the United States: a policy statement from the American Heart Association. Circulation. 2011;123(8):933–44.

    Article  PubMed  Google Scholar 

  2. Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Borden WB, et al. Heart disease and stroke statistics—2013 update: a report from the American Heart Association. Circulation. 2013;127(1):e6–245.

    Article  PubMed  Google Scholar 

  3. Kannel WB. Blood pressure as a cardiovascular risk factor: prevention and treatment. JAMA. 1996;275(20):1571–6.

    Article  CAS  PubMed  Google Scholar 

  4. Criqui MH, Langer RD, Fronek A, Feigelson HS, Klauber MR, McCann TJ, et al. Mortality over a period of 10 years in patients with peripheral arterial disease. N Engl J Med. 1992;326(6):381–6. Epub 1992/02/06.

    Article  CAS  PubMed  Google Scholar 

  5. Klag MJ, Whelton PK, Randall BL, Neaton JD, Brancati FL, Ford CE, et al. Blood pressure and end-stage renal disease in men. N Engl J Med. 1996;334(1):13–8. Epub 1996/01/04.

    Article  CAS  PubMed  Google Scholar 

  6. Kannel WB, Dawber TR, Kagan A, Revotskie N, Stokes 3rd J. Factors of risk in the development of coronary heart disease–six year follow-up experience. The Framingham Study. Ann Intern Med. 1961;55:33–50. Epub 1961/07/01.

    Article  CAS  PubMed  Google Scholar 

  7. Multiple risk factor intervention trial. Risk factor changes and mortality results. Multiple Risk Factor Intervention Trial Research Group. JAMA. 1982;248(12):1465–77. Epub 1982/09/24.

    Google Scholar 

  8. Stamler J, Neaton JD, Wentworth DN. Blood pressure (systolic and diastolic) and risk of fatal coronary heart disease. Hypertension. 1989;13(5 Suppl):I2–12. Epub 1989/05/01.

    Article  CAS  PubMed  Google Scholar 

  9. Lewington S, Clarke R, Qizilbash N, Peto R, Collins R. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet. 2002;360(9349):1903–13. Epub 2002/12/21.

    Article  PubMed  Google Scholar 

  10. Gu Q, Burt VL, Dillon CF, Yoon S. Trends in antihypertensive medication use and blood pressure control among United States adults with hypertension: the National Health And Nutrition Examination Survey, 2001 to 2010. Circulation. 2012;126(17):2105–14. Epub 2012/10/24.

    Article  CAS  PubMed  Google Scholar 

  11. Smith Jr SC, Jackson R, Pearson TA, Fuster V, Yusuf S, Faergeman O, et al. Principles for national and regional guidelines on cardiovascular disease prevention: a scientific statement from the World Heart and Stroke Forum. Circulation. 2004;109(25):3112–21. Epub 2004/07/01.

    Article  PubMed  Google Scholar 

  12. Mancia G, De Backer G, Dominiczak A, Cifkova R, Fagard R, Germano G, et al. 2007 ESH-ESC Practice Guidelines for the Management of Arterial Hypertension: ESH-ESC Task Force on the Management of Arterial Hypertension. J Hypertens. 2007;25(9):1751–62. Epub 2007/09/01.

    Article  CAS  PubMed  Google Scholar 

  13. Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Bohm M, et al. 2013 ESH/ESC guidelines for the management of arterial hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J. 2013;34(28):2159–219. Epub 2013/06/19.

    Article  PubMed  Google Scholar 

  14. Effects of treatment on morbidity in hypertension. Results in patients with diastolic blood pressures averaging 115 through 129 mm Hg. JAMA. 1967;202(11):1028–34. Epub 1967/12/11.

    Google Scholar 

  15. Veterans Administration Cooperative Study Group on Antihypertensive Agents. Effects of treatment on morbidity in hypertension: II. Results in patients with diastolic blood pressure averaging 90 through 114 mmHg. JAMA. 1970;213:1143–52.

    Google Scholar 

  16. Freis ED, Ragan D. Effect of treatment on longevity in spontaneously hypertensive rats. Proc Soc Exp Biol Med. 1975;150:422–4.

    Article  CAS  PubMed  Google Scholar 

  17. The Edward D. Freis papers. The VA Cooperative Study and the beginning of routine hypertension screening, 1964–1980. http://profiles.nlm.nih.gov/ps/retrieve/Narrative/XF/p-nid/172.

  18. National High Blood Pressure Education Program (NHBPEP) Working Group Report on Hypertension and Chronic Renal Failure. Washington, DC: US Dept of Health and Human Services, Public Health Service; 1990. NIH publication 90–3032. National High Blood Pressure Education Program. http://www.nhlbi.nih.gov/about/nhbpep/nhbp_pd.htm.

  19. O’Donnell MJ, Xavier D, Liu L, Zhang H, Chin SL, Rao-Melacini P, et al. Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): a case–control study. Lancet. 2010;376(9735):112–23. Epub 2010/06/22.

    Article  PubMed  Google Scholar 

  20. Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case–control study. Lancet. 2004;364(9438):937–52. Epub 2004/09/15.

    Article  PubMed  Google Scholar 

  21. Neal B, MacMahon S, Chapman N. Effects of ACE inhibitors, calcium antagonists, and other blood-pressure-lowering drugs: results of prospectively designed overviews of randomised trials. Blood Pressure Lowering Treatment Trialists’ Collaboration. Lancet. 2000;356(9246):1955–64. Epub 2000/12/29.

    Article  CAS  PubMed  Google Scholar 

  22. Turnbull F. Effects of different blood-pressure-lowering regimens on major cardiovascular events: results of prospectively-designed overviews of randomised trials. Lancet. 2003;362(9395):1527–35.

    Article  CAS  PubMed  Google Scholar 

  23. Psaty BM, Lumley T, Furberg CD, Schellenbaum G, Pahor M, Alderman MH, et al. Health outcomes associated with various antihypertensive therapies used as first-line agents: a network meta-analysis. JAMA. 2003;289(19):2534–44.

    Article  CAS  PubMed  Google Scholar 

  24. Dahlöf B, Devereux RB, Kjeldsen SE, Julius S, Beevers G, Faire U, et al. Cardiovascular morbidity and mortality in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol. Lancet. 2002;359(9311):995–1003.

    Article  PubMed  Google Scholar 

  25. Julius S, Kjeldsen SE, Weber M, Brunner HR, Ekman S, Hansson L, et al. Outcomes in hypertensive patients at high cardiovascular risk treated with regimens based on valsartan or amlodipine: the VALUE randomised trial. Lancet. 2004;363(9426):2022–31. Epub 2004/06/23.

    Article  CAS  PubMed  Google Scholar 

  26. Jamerson K, Weber MA, Bakris GL, Dahlöf B, Pitt B, Shi V, et al. Benazepril plus amlodipine or hydrochlorothiazide for hypertension in high-risk patients. N Engl J Med. 2008;359(23):2417–28. Epub 2008/12/05.

    Article  CAS  PubMed  Google Scholar 

  27. ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA. 2002;288(23):2981–97.

    Article  Google Scholar 

  28. Turnbull F, Neal B, Algert C, Chalmers J, Chapman N, Cutler J, et al. Effects of different blood pressure-lowering regimens on major cardiovascular events in individuals with and without diabetes mellitus: results of prospectively designed overviews of randomized trials. Arch Intern Med. 2005;165(12):1410–9.

    Article  PubMed  Google Scholar 

  29. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo Jr JL, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003;289(19):2560–72. Epub 2003/05/16.

    Article  CAS  PubMed  Google Scholar 

  30. James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014;311:507–20.

    Article  CAS  PubMed  Google Scholar 

  31. Hansson L, Lindholm LH, Niskanen L, Lanke J, Hedner T, Niklason A, et al. Effect of angiotensin-converting-enzyme inhibition compared with conventional therapy on cardiovascular morbidity and mortality in hypertension: the Captopril Prevention Project (CAPPP) randomised trial. Lancet. 1999;353(9153):611–6.

    Article  CAS  PubMed  Google Scholar 

  32. Hansson L, Hedner T, Lund-Johansen P, Kjeldsen SE, Lindholm LH, Syvertsen JO, et al. Randomised trial of effects of calcium antagonists compared with diuretics and beta-blockers on cardiovascular morbidity and mortality in hypertension: the Nordic Diltiazem (NORDIL) study. Lancet. 2000;356(9227):359–65. Epub 2000/09/06.

    Article  CAS  PubMed  Google Scholar 

  33. Lewis EJ, Hunsicker LG, Bain RP, Rohde RD. The effect of angiotensin-converting-enzyme inhibition on diabetic nephropathy. The Collaborative Study Group [see comments] [published erratum appears in N Engl J Med 1993 Jan 13; 330(2):152]. N Engl J Med. 1993;329(20):1456–62.

    Article  CAS  PubMed  Google Scholar 

  34. Wright Jr JT, Bakris G, Greene T, Agodoa LY, Appel LJ, Charleston J, et al. Effect of blood pressure lowering and antihypertensive drug class on progression of hypertensive kidney disease: results from the AASK trial. JAMA. 2002;288(19):2421–31. Epub 2002/11/21.

    Article  CAS  PubMed  Google Scholar 

  35. Lewis EJ, Hunsicker LG, Clarke WR, Berl T, Pohl MA, Lewis JB, et al. Renoprotective effect of the angiotensin-receptor antagonist irbesartan in patients with nephropathy due to type 2 diabetes. N Engl J Med. 2001;345(12):851–60.

    Article  CAS  PubMed  Google Scholar 

  36. Brenner BM, Cooper ME, de Zeeuw D, Keane WF, Mitch WE, Parving HH, et al. Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy. N Engl J Med. 2001;345(12):861–9.

    Article  CAS  PubMed  Google Scholar 

  37. The SOLVD Investigators. Effect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure. N Engl J Med. 1991;325(5):293–302.

    Article  Google Scholar 

  38. Cohn JN, Johnson G, Ziesche S, Cobb F, Francis F, Tristani F, et al. A comparison of enalapril with hydralazine – isosorbide dinitrate in the treatment of chronic congestive heart failure. N Engl J Med. 1991;325:303–10.

    Article  CAS  PubMed  Google Scholar 

  39. Granger CB, McMurray JJ, Yusuf S, Held P, Michelson EL, Olofsson B, et al. Effects of candesartan in patients with chronic heart failure and reduced left-ventricular systolic function intolerant to angiotensin-converting-enzyme inhibitors: the CHARM-Alternative trial. Lancet. 2003;362(9386):772–6.

    Article  CAS  PubMed  Google Scholar 

  40. The SOLVD Investigators. Effect of enalapril on mortality and the development of heart failure in asymptomatic patients with reduced left ventricular ejection fractions. N Engl J Med. 1992;327:685–91.

    Article  Google Scholar 

  41. Pfeffer MA, Braunwald E, Moyé LA, Basta L, Brown Jr EJ, Cuddy TE, et al. Effect of captopril on mortality and morbidity in patients with left ventricular dysfunction after myocardial infarction. Results of the survival and ventricular enlargement trial. The SAVE Investigators. N Engl J Med. 1992;327:669–77.

    Article  CAS  PubMed  Google Scholar 

  42. Flather MD, Yusuf S, Køber L, Pfeffer M, Hall A, Murray G, et al. Long-term ACE-inhibitor therapy in patients with heart failure or left-ventricular dysfunction: a systematic overview of data from individual patients. ACE-Inhibitor Myocardial Infarction Collaborative Group. Lancet. 2000;355:1575–81.

    Article  CAS  PubMed  Google Scholar 

  43. Yusuf S, Sleight P, Pogue J, Bosch J, Davies R, Dagenais G. Effects of an angiotensin-converting-enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. The Heart Outcomes Prevention Evaluation Study Investigators. N Engl J Med. 2000;342(3):145–53.

    Article  CAS  PubMed  Google Scholar 

  44. Fox KM, Henderson JR, Bertrand ME, Ferrari R, Remme WJ, Simoons ML. The European trial on reduction of cardiac events with perindopril in stable coronary artery disease (EUROPA). Eur Heart J. 1998;19(Suppl J):J52–5.

    CAS  PubMed  Google Scholar 

  45. Dagenais GR, Pogue J, Fox K, Simoons ML, Yusuf S. Angiotensin-converting-enzyme inhibitors in stable vascular disease without left ventricular systolic dysfunction or heart failure: a combined analysis of three trials. Lancet. 2006;368(9535):581–8.

    Article  CAS  PubMed  Google Scholar 

  46. Pfeffer JM, Pfeffer MA, Fletcher PJ, Braunwald E. Alterations of cardiac performance in rats with established spontaneous hypertension. Am J Cardiol. 1979;44:994–8.

    Article  CAS  PubMed  Google Scholar 

  47. Pfeffer JM, Pfeffer MA, Mirsky I, Braunwald E. Regression of left ventricular hypertrophy and prevention of left ventricular dysfunction by captopril in the spontaneously hypertensive rat. Proc Natl Acad Sci U S A. 1982;79(10):3310–4.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  48. Pfeffer JM, Pfeffer MA, Mirsky I, Braunwald E. Prevention of the development of heart failure and the regression of cardiac hypertrophy by captopril in the spontaneously hypertensive rat. Eur Heart J. 1983;4(Suppl A):143–8.

    Article  CAS  PubMed  Google Scholar 

  49. Pfeffer JM, Pfeffer MA, Fletcher PJ, Braunwald E. Progressive ventricular remodeling in rat with myocardial infarction. Am J Physiol. 1991;260(5 Pt 2):H1406–14.

    CAS  PubMed  Google Scholar 

  50. Pfeffer MA, Braunwald E. Ventricular remodeling after myocardial infarction. Experimental observations and clinical implications. Circulation. 1990;81(4):1161–72.

    Article  CAS  PubMed  Google Scholar 

  51. Hammermeister KE, DeRouen TA, Dodge HT. Variables predictive of survival in patients with coronary disease: selection by univariate and multivariate analyses from the clinical, electrocardiographic, exercise, arteriographic, and quantitative angiographic evaluations. Circulation. 1979;59:421–30.

    Article  CAS  PubMed  Google Scholar 

  52. White HD, Norris RM, Brown MA, Brandt PWT, Whitlock RML, Wild CJ. Left ventricular end-systolic volume as the major determinant of survival after recovery from myocardial infarction. Circulation. 1987;76:44–51.

    Article  CAS  PubMed  Google Scholar 

  53. Cupples LA, D’Agostino RB. Some risk factors related to the annual incidence of cardiovascular disease and death using pooled repeated biennial measurements: Framingham Heart Study, 30-year follow up. In: Kannel WB, Wolf PA, Garrison RI, editors. The Framingham Study: An Epidemiological Investigation of Cardiovascular Disease. Section 34. DHHS publication no. (NIH) 87–2703. Washington DC: U.S. Government Printing Office; 1987. p. 9–20.

    Google Scholar 

  54. Pfeffer JM, Pfeffer MA, Fishbein MC, Frohlich ED. Cardiac function and morphology with aging in the spontaneously hypertensive rat. Am J Physiol. 1979;237(4):H461–8.

    CAS  PubMed  Google Scholar 

  55. Pfeffer JM, Pfeffer MA, Braunwald E. Influence of chronic captopril therapy on the infarcted left ventricle of the rat. Circ Res. 1985;57(1):84–95.

    Article  CAS  PubMed  Google Scholar 

  56. Pfeffer JM, Pfeffer MA, Braunwald E. Hemodynamic benefits and prolonged survival with long-term captopril therapy in rats with myocardial infarction and heart failure. Circulation. 1987;75(1 Pt 2):I149–55.

    CAS  PubMed  Google Scholar 

  57. Pfeffer MA, Pfeffer JM, Steinberg C, Finn P. Survival after an experimental myocardial infarction: beneficial effects of long-term therapy with captopril. Circulation. 1985;72(2):406–12.

    Article  CAS  PubMed  Google Scholar 

  58. Pfeffer MA, Lamas GA, Vaughan DE, Parisi AF, Braunwald E. Effect of captopril on progressive ventricular dilatation after anterior myocardial infarction. N Engl J Med. 1988;319(2):80–6.

    Article  CAS  PubMed  Google Scholar 

  59. St John Sutton M, Pfeffer MA, Plappert T, Rouleau JL, Moye LA, Dagenais GR, et al. Quantitative two-dimensional echocardiographic measurements are major predictors of adverse cardiovascular events after acute myocardial infarction. The protective effects of captopril. Circulation. 1994;89(1):68–75.

    Article  CAS  PubMed  Google Scholar 

  60. Effects of lisinopril and transdermal glyceryl trinitrate singly and together on 6-week mortality and ventricular function after acute myocardial infarction. Gruppo Italiano per lo Studio della Sopravvivenza Nell’Infarto Miocardico (GISSI)-3. Lancet. 1994;343:1115–22.

    Google Scholar 

  61. Fourth International Study of Infarct Survival (ISIS-4): a randomised factorial trial assessing early oral captopril, oral mononitrate, and intravenous magnesium sulphate in 58,050 patients with suspected acute myocardial infarction. Lancet. 1995;345:669–85.

    Google Scholar 

  62. Latini R, Tognoni G, Maggioni AP, Baigent C, Braunwald E, Chen ZM, et al. Clinical effects of early angiotensin-converting enzyme inhibitor treatment for acute myocardial infarction are similar in the presence and absence of aspirin: systematic overview of individual data from 96,712 randomized patients. J Am Coll Cardiol. 2000;35(7):1801–7. Epub 2000/06/07.

    Article  CAS  PubMed  Google Scholar 

  63. Antman EM, Anbe DT, Armstrong PW, Bates ER, Green LA, Hand M, et al. ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction–executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1999 Guidelines for the Management of Patients With Acute Myocardial Infarction). Circulation. 2004;110(5):588–636.

    Article  PubMed  Google Scholar 

  64. Dickstein K, Kjekshus J. Effects of losartan and captopril on mortality and morbidity in high-risk patients after acute myocardial infarction: the OPTIMAAL randomised trial. Optimal Trial in Myocardial Infarction with Angiotensin II Antagonist Losartan. Lancet. 2002;360(9335):752–60.

    Article  CAS  PubMed  Google Scholar 

  65. Pfeffer MA, McMurray JJ, Velazquez EJ, Rouleau JL, Køber L, Maggioni AP, et al. Valsartan, captopril, or both in myocardial infarction complicated by heart failure, left ventricular dysfunction, or both. N Engl J Med. 2003;349(20):1893–906.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Cardiology, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA

    Marc A. Pfeffer MD, PhD

Authors
  1. Marc A. Pfeffer MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Marc A. Pfeffer MD, PhD .

Editor information

Editors and Affiliations

  1. Hôtel-Dieu Hospital Diagnosis and Therapeutics Center, Paris Descartes University, Paris, Paris, France

    Michel E. Safar

  2. St Vincent Clinic and Hospital, University of New South Wales, Victor Chang Cardiac Research Institute, Darlinghurst, Sydney, New South Wales, Australia

    Michael F. O'Rourke

  3. Department of Cardiology, Ochsner Clinic Foundation, New Orleans, Louisiana, USA

    Edward D. Frohlich

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer-Verlag London

About this chapter

Cite this chapter

Pfeffer, M.A. (2014). Preventive Lessons from Hypertension and Myocardial Infarction: Treating Asymptomatic Individuals to Lower the Risk for Subsequent Cardiovascular Events. In: Safar, M., O'Rourke, M., Frohlich, E. (eds) Blood Pressure and Arterial Wall Mechanics in Cardiovascular Diseases. Springer, London. https://doi.org/10.1007/978-1-4471-5198-2_19

Download citation

  • DOI: https://doi.org/10.1007/978-1-4471-5198-2_19

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-5197-5

  • Online ISBN: 978-1-4471-5198-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation