2017 and Hypertension: A year in review

Edited by Costas Tsioufis and Alex Kasiakogias

We have now entered the new year so let us look back at 2017 and see what it offered us! The previous year was very generous in the area of hypertension and cardiovascular prevention research, and so there is a substantial number of good reads. From research articles to expert reviews, we present you a list of a few choice articles of interest for the practicing physician that are either representative of trending research or caught our attention for their intriguing subject.

Research articles in 2017: 10 picks to start with

Achieved blood pressure and cardiovascular outcomes in high-risk patients: results from ONTARGET and TRANSCEND trials
Böhm M, Schumacher H, PhD, Teo KK et al. Lancet. 2017; 389(10085):2226-2237.

Mean achieved SBP less than 120 mm Hg during treatment was associated with increased risk of cardiovascular outcomes except for myocardial infarction and stroke. These data suggest that the lowest blood pressure possible is not necessarily the optimal target for high-risk patients, although it is not possible to rule out some effect of reverse causality.

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Protective effects of antihypertensive treatment in patients aged 85 years or older
Corrao G, Rea F, Monzio Compagnoni M et al. J Hypertens. 2017; 35(7):1432-1441.

Adherence with antihypertensive drug therapy reduced the risk of cardiovascular morbidity in patients aged 85 years or more, the benefit including heart failure and stroke, although not MI, and extending to all-cause death.

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Effects of blood-pressure-lowering treatment on outcome incidence in hypertension. 11. Effects of total cardiovascular risk and achieved blood pressure: overview and meta-analyses of randomized trials
Thomopoulos C, Parati G, Zanchetti A. J Hypertens. 2017; 35(11):2138-2149.

A high level of cardiovascular risk is not in itself a restraint to target at SBP values less than 130 mmHg, if treatment is well tolerated. Though a high cardiovascular risk associated with diabetes is not an indication for aiming at SBP less than 130 mmHg, current evidence is that SBP values slightly below 130 mmHg are not associated with harm.

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Day-to-day blood pressure variability and risk of dementia in a general Japanese elderly Population: The Hisayama Study.
Oishi E, Ohara T, Sakata S et al. Circulation. 2017; 136(6):516-525.

Our findings suggest that increased day-to-day blood pressure variability is, independently of average home blood pressure, a significant risk factor for the development of all-cause dementia, vascular dementia, and Alzheimer disease in the general elderly Japanese population.

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Effects of Sacubitril/Valsartan (LCZ696) on natriuresis, diuresis, blood pressures, and NT-proBNP in salt-sensitive hypertension
Wang TD, Tan RS, Lee HY et al. Hypertension. 2017; 69(1):32-41.

Sacubitril/valsartan compared with valsartan was associated with short-term increases in natriuresis and diuresis, superior office and ambulatory blood pressure control, and significantly reduced N-terminal pro B-type natriuretic peptide levels in Asian patients with salt sensitive hypertension.

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Effect of intensive blood-pressure treatment on patient-reported outcomes
Berlowitz DR, Foy CG, Kazis LE et al. N Engl J Med. 2017; 377(8):733-744.

Patient-reported outcomes among participants who received intensive treatment, which targeted a systolic blood pressure of less than 120 mm Hg, were similar to those among participants who received standard treatment, including among participants with decreased physical or cognitive function.

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Prevalence and clinical characteristics of white-coat hypertension based on different definition criteria in untreated and treated patients
de la Sierra A, Vinyoles E, Banegas JR et al. J Hypertens. 2017; 35(12):2388-2394.

Prevalence of WCH is dependent on definition criteria. Only diagnostic criteria which considers the normality of all ambulatory periods identifies patients with cardiovascular risk similar to normotensive patients.

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Cigarette smoking and subtypes of uncontrolled blood pressure among diagnosed hypertensive patients: paradoxical associations and implications
Liu X, Byrd JB. Am J Hypertens. 2017; 30(6):602-609.

Paradoxical associations between current smoking and SBP, uncontrolled BP and isolated uncontrolled SBP were shown among hypertensive patients. The explanation for these associations is currently unknown. No cause-effect relationships should be assumed

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Catheter-based renal denervation in patients with uncontrolled hypertension in the absence of antihypertensive medications (SPYRAL HTN-OFF MED): a randomised, sham-controlled, proof-of-concept trial
Townsend RR, Mahfoud F, Kandzari DE et al. Lancet. 2017; 390(10108):2160-2170.

Results from SPYRAL HTN-OFF MED provide biological proof of principle for the blood-pressure-lowering efficacy of renal denervation.

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The importance of breakfast in atherosclerosis disease: insights from the PESA study
Uzhova I, Fuster V, Fernández-Ortiz A et al. J Am Coll Cardiol. 2017; 70(15):1833-1842.

Skipping breakfast is associated with an increased odds of prevalent noncoronary and generalized atherosclerosis independently of the presence of conventional CV risk factors.

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