Continuation of the ESH-CHL-SHOT trial after publication of the SPRINT: rationale for further study on blood pressure targets of antihypertensive treatment after stroke

Result code in IS VaVaI
<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00064190%3A_____%2F16%3AN0000095" target="_blank" >RIV/00064190:_____/16:N0000095 - isvavai.cz</a>
Result on the web
<a href="http://dx.doi.org/10.1097/HJH.0000000000000853" target="_blank" >http://dx.doi.org/10.1097/HJH.0000000000000853</a>
DOI - Digital Object Identifier
<a href="http://dx.doi.org/10.1097/HJH.0000000000000853" target="_blank" >10.1097/HJH.0000000000000853</a>

Result language
angličtina
Original language name
Continuation of the ESH-CHL-SHOT trial after publication of the SPRINT: rationale for further study on blood pressure targets of antihypertensive treatment after stroke
Original language description
All major recent guidelines on hypertension management acknowledge that evidence from randomized controlled trials (RCTs) is scanty and controversial about the levels to which blood pressure (BP) should be brought by antihypertensive treatment, in both primary and secondary prevention. Although observational studies have shown that there isa direct relationship between SBP and DBP and majorcardiovascular events [both stroke and coronary heart dis-ease (CHD) events] down to 115 mmHg SBP and 75 mmHgDBP [4], the numerous randomized trials that have dem-onstrated the benefits of BP lowering have very rarelybrought SBP below 130 mmHg, and in most RCTs activetreatment achieved SBP values either between 140 and150 mmHg or a few mmHg below 140 mmHg [1]. Datasuggesting that risk of cardiovascular disease events maybe less effectively prevented when SBP (or DBP) is loweredbelow a given level (so called J-shaped curve) can only beconsidered hypothesis raising, as the type of analysis used(plotting incident outcomes against achieved BP independ-ently of the randomized group) is an analysis of observa-tional data, even if data are collected within a randomizedtrial.
Czech name
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Czech description
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Type
J<sub>x</sub> - Unclassified - Peer-reviewed scientific article (Jimp, Jsc and Jost)
CEP classification
FA - Cardiovascular diseases including cardio-surgery
OECD FORD branch
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Publication year
2016
Confidentiality
S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

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