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Antihypertensive Therapy Benefits: Pleiotropic Versus Blood Pressure-Dependent Mechanisms

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Special Issues in Hypertension

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Abstract

The accumulated evidence from numerous trials in many thousands of individuals with high blood pressure indicates that, compared with placebo or control therapy, antihypertensive drug treatment reduces the risk of stroke, coronary heart disease and progression of renal impairment. Benefits are seen in systolic and diastolic hypertension, in mild-to-moderate hypertension, in all age groups, and they appear to be constant in proportion across the blood pressure range. People at all levels of risk benefit; therefore, the bigger the absolute risk, the greater the absolute benefit. A comprehensive meta-analysis of the results of 147 randomized trials involving 464,000 people in the context of epidemiological data from 958,000 people indicated that the proportional reduction in cardiovascular disease events is the same or similar regardless of pretreatment blood pressure and the presence or absence of cardiovascular disease. Thus, whatever the risk level, comorbidity, or special groups, the most important thing is to lower blood pressure properly. All the different common antihypertensive drugs and most drug combinations can be used if well tolerated.

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Authors and Affiliations

  1. Department of Cardiology, Ullevaal and Faculty of Medicine, Oslo University Hospital, University of Oslo, Oslo, NA, Norway

    Sverre E. Kjeldsen

  2. Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, Scotland, London

    Gordon T. McInnes

Authors
  1. Sverre E. Kjeldsen
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  2. Gordon T. McInnes
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Correspondence to Sverre E. Kjeldsen .

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Editors and Affiliations

  1. , Internal Medicine, American University of Beirut Medical Ce, Riad El Solh, Beirut, 1107-2020, Lebanon

    Adel E. Berbari

  2. Clinica Medica, Ospedale S. Gerardo, Università di Milano-Bicocca, V .Donizetti 106, Milano, Monza, 20133, Italy

    Giuseppe Mancia

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© 2012 Springer-Verlag Italia

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Kjeldsen, S.E., McInnes, G.T. (2012). Antihypertensive Therapy Benefits: Pleiotropic Versus Blood Pressure-Dependent Mechanisms. In: Berbari, A., Mancia, G. (eds) Special Issues in Hypertension. Springer, Milano. https://doi.org/10.1007/978-88-470-2601-8_20

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  • DOI: https://doi.org/10.1007/978-88-470-2601-8_20

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  • Print ISBN: 978-88-470-2600-1

  • Online ISBN: 978-88-470-2601-8

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