¿Qué tan baja debe ser la presión arterial en estos pacientes? | 23 MAY 23

Umbrales de presión arterial en las enfermedades coronaria y cerebrovascular crónicas

Este artículo revisa la evidencia, las controversias y el estado actual del conocimiento sobre el descenso intensivo de la PA y los umbrales más bajos a alcanzar en pacientes con enfermedades coronarias o cerebrovasculares crónicas.
Autor/a: A.J. Manolis M. S. Kallistratos, M. Camafort, A. Coca How low should blood pressure be in patients with chronic coronary and cerebrovascular diseases
INDICE:  1. Texto principal | 2. Texto principal
Texto principal

[1] Roth GA, Mensah GA, 4Johnson CO, Addolorato G, Ammirati E, Baddour LM, Barengo NC, Beaton AZ, Benjamin EJ, Benziger CP, Bonny A, Brauer M, Brodmann M, Cahill TJ, Carapetis J, Catapano AL, Chugh SS, Cooper LT, Coresh J, Criqui M, DeCleene N, Eagle KA, Emmons-Bell S, Feigin VL, Fern´andez-Sol`a J, Fowkes G, Gakidou E, Grundy SM, He FJ, Howard G, Hu F, Inker L, Karthikeyan G, Kassebaum N, Koroshetz W, Lavie C, Lloyd-Jones D, Lu HS, Mirijello A, Temesgen AM, Mokdad A, Moran AE, Muntner P, Narula J, Neal B, Ntsekhe M, Moraes de Oliveira G, Otto C, Owolabi M, Pratt M, Rajagopalan S, Reitsma M, Ribeiro ALP, Rigotti N, Rodgers A, Sable C, Shakil S, Sliwa-Hahnle K, Stark B, Sundstr¨om J, Timpel P, Tleyjeh IM, Valgimigli M, Vos T, Whelton PK, Yacoub M, Zuhlke L, Murray C, Fuster V, GBD-NHLBI-JACC Global Burden of Cardiovascular Diseases Writing Group. Global burden of cardiovascular diseases and risk factors, 1990-2019: update from the GBD 2019 study. J Am Coll Cardiol 2020;76(25): 2982–3021.

[2] Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, Clement DL, Coca A, de Simone G, Dominiczak A, Kahan T, Mahfoud F, Redon J, Ruilope L, Zanchetti A, Kerins M, Kjeldsen SE, Kreutz R, Laurent S, Lip GYH, McManus R, Narkiewicz K, Ruschitzka F, Schmieder RE, Shlyakhto E, Tsioufis C, Aboyans V, Desormais I, ESC Scientific Document Group. 2018 ESC/ESH guidelines for the management of arterial hypertension. Eur Heart J 2018;39(33):3021–104.

[3] Franklin SS, Khan SA, Wong ND, Larson MG, Levy D. Is pulse pressure useful in predicting risk for coronary heart Disease? The Framingham heart study. Circulation 1999;100(4):354–60.

[4] Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F, McQueen M, Budaj A, Pais P, Varigos J, Lisheng L, INTERHEART Study Investigators. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet 2004;364:937–52.

[5] 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 North Am Ed 2010;376(9735): 112–23.

[6] Ettehad D, Emdin CA, Kiran A, Anderson SG, Callender T, Emberson J, Chalmers J, Rodgers A, Rahimi K. Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis. Lancet 2016;387 (10022):957–67.

[7] Cooper-DeHoff RM, Handberg EM, Mancia G, Zhou Q, Champion A, Legler UF, Pepine CJ. INVEST revisited: review of findings from the International Verapamil SR-Trandolapril Study. Expert Rev Cardiovasc Ther 2009;7(11):1329–40.

[8] Julius S, Kjeldsen SE, Weber M, Brunner HR, Ekman S, Hansson L, Hua T, Laragh J, McInnes GT, Mitchell L, Plat F, Schork A, Smith B, Zanchetti A. VALUE trial group. 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.

[9] Bangalore S, Messerli FH, Wun CC, Zuckerman AL, DeMicco D, Kostis JB, LaRosa JC. Treating to new targets steering committee and investigators. J-curve revisited: an analysis of blood pressure and cardiovascular events in the Treating to New Targets (TNT) Trial. Eur Heart J 2010;31(23):2897–908.

[10] ONTARGET Investigators, Yusuf S, Teo KK, Pogue J, Dyal L, Copland I, Schumacher H, Dagenais G, Sleight P, Anderson C. Telmisartan, ramipril, or both in patients at high risk for vascular events. N Engl J Med 2008;358(15):1547–59.

[11] SPRINT Research Group, Wright Jr JT, Williamson JD, Whelton PK, Snyder JK, Sink KM, Rocco MV, Reboussin DM, Rahman M, Oparil S, Lewis CE, Kimmel PL, Johnson KC, Goff Jr DC, Fine LJ, Cutler JA, Cushman WC, Cheung AK, Ambrosius WT. A randomized trial of intensive versus standard blood-pressure control. N Engl J Med 2015;373(22):2103–16.

[12] Whelton PK, Carey RM, Aronow WS, Casey Jr DE, Collins KJ, Dennison Himmelfarb C, DePalma SM, Gidding S, Jamerson KA, Jones DW, MacLaughlin EJ, Muntner P, Ovbiagele B, Smith Jr SC, Spencer CC, Stafford RS, Taler SJ, Thomas RJ, Williams Sr KA, Williamson JD, Wright Jr JT. 2017 ACC/AHA/AAPA/ ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the american college of cardiology/American Heart association task force on clinical practice guidelines. Hypertension 2018;71(6):e13–115.

[13] Unger T, Borghi C, Charchar F, Khan NA, Poulter NR, Prabhakaran D, Ramirez A, Schlaich M, Stergiou GS, Tomaszewski M, Wainford RD, Williams B, Schutte AE. 2020 international society of hypertension global hypertension practice guidelines. J Hypertens 2020;38(6):982–1004.

[14] Thomopoulos C, Parati G, Zanchetti A. Effects of blood pressure lowering on outcome incidence in hypertension: 2. Effects at different baseline and achieved blood pressure levels–overview and meta-analyses of randomized trials. J Hypertens 2014;32(12):2296–304.

[5] Morita K, Mori H, Tsujioka K, Kimura A, Ogasawara Y, Goto M, Hiramatsu O, Kajiya F, Feigl EO. Alpha-adrenergic vasoconstriction reduces systolic retrograde coronary blood flow. Am J Physiol 1997;273:H2746–55.

[16] Tsika EP, Poulimenos LE, Boudoulas KD, Manolis AJ. The J-curve in arterial hypertension: fact or fallacy? Cardiology 2014;129(2):126–35.

[17] Boudoulas H, Rittgers SE, Lewis RP, Leier CV, Weissler AM. Changes in diastolic time with various pharmacologic agents: implication for myocardial perfusion. Circulation 1979;60:164–9.

[18] Vidal-Petiot E, Ford I, Greenlaw N, Ferrari R, Fox KM, Tardif JC, Tendera M, Tavazzi L, Bhatt DL. Steg PG; CLARIFY investigators. Cardiovascular event rates and mortality according to achieved systolic and diastolic blood pressure in patients with stable coronary artery disease: an international cohort study. Lancet 2016;388(10056):2142–52.

[19] McEvoy JW, Chen Y, Rawlings A, Hoogeveen RC, Ballantyne CM, Blumenthal RS, Coresh J, Selvin E. Diastolic blood pressure, subclinical myocardial damage, and cardiac events: implications for blood pressure control. J Am Coll Cardiol 2016;68 (16):1713–22.

[20] Manolis AJ, Kallistratos MS, LЕ P, Ambrosio G, Dechend R, Lopez-Sendon J, Rosano G, Collins P. The ESC 2019 CCS guidelines: have we left our patients and scientific evidence behind? Eur J Intern Med 2020;72:5–8.

[21] ACCORD Study Group, Cushman WC, Evans GW, Byington RP, Jr GDC, Jr GRH, Cutler JA, Simons-Morton DG, Basile JN, Corson MA, Probstfield JL, Katz L, Peterson KA, Friedewald WT, Buse JB, Bigger JT, Gerstein HC, Ismail-Beigi F. Effects of intensive blood-pressure control in type 2 diabetes mellitus. N Engl J Med 2010;362(17):1575–85. https://doi.org/10.1056/NEJMoa1001286.

[22] Boutitie F, Gueyffier F, Pocock S, Fagard R, Boissel JP. INDANA project steering committee. INdividual data analysis of antihypertensive intervention. J-shaped relationship between blood pressure and mortality in hypertensive patients: new insights from a meta-analysis of individual-patient data. Ann Intern Med 2002;136 (6):438–48. https://doi.org/10.7326/0003-4819-136-6-200203190-00007.

[23] Reboldi G, Angeli F, Gentile G, Verdecchia P. Benefits of more intensive versus less intensive blood pressure control. Updated trial sequential analysis. Eur J Intern Med 2022;101:49–55. https://doi.org/10.1016/j.ejim.2022.03.032.

[24] Manolis AJ, Kallistratos MS, Poulimenos LE. Angina and hypertension. Eur Heart J Suppl 2019;21(Suppl C):C15–6.

[25] Kallistratos MS, Poulimenos LE, Manolis AJ. Beta blockers, calcium channel blockers, and long-acting nitrates for patients with stable angina and low blood pressure levels: should this recommendation be reconsidered? Eur Heart J 2020;41 (3):479.

[26] Manolis AJ, Kallistratos MS. Recent published hypertension guidelines: a critical approach. Eur J Intern Med 2019;63:1–2.

[27] Pantoni L. Cerebral small vessel disease: from pathogenesis and clinical characteristics to therapeutic challenges. Lancet Neurol 2010;9:689–701.

[28] Sierra C, Camafort M, Coca A. Structural and functional aspects of brain damage. Mancia G, Grassi G, Dominiczak AF, Tsioufis K, Agabiti-Rosei E. Manual of hypertension of the European society of hypertension. Boca Raton, Florida, USA: CRC Press; 2020. p. 241–6.

[29] Lewington S, Clarke R, Qizilbash N, Peto R, Collins R, Prospective Studies Collaboration. 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.

[30] Rapsomaniki E, Timmis A, George J, Pujades-Rodriguez M, Shah AD, Denaxas S, et al. Blood pressure and incidence of twelve cardiovascular diseases: lifetime risks, healthy life-years lost, and age-specific associations in 1,25million people. Lancet 2014;383(9932):1899–911.

[31] Singh GM, Danaei G, Farzadfar F, Stevens GA, Woodward M, Wormser D, et al. The age-specific quantitative effects of metabolic risk factors on cardiovascular diseases and diabetes: a pooled analysis. PLoS One 2013;8(7):e65174.

[32] Lawes CM, Rodgers A, Bennett DA, Parag V, Suh I, Ueshima H, et al. Blood pressure and cardiovascular disease in the Asia Pacific region. J Hypertens 2003;21(4): 707–16.

[33] Thomopoulos C, Parati G, Zanchetti A. Effects of blood pressure lowering on outcome incidence in hypertension. 1. Overview, meta-analyses, an metaregression analyses of randomized trials. J Hypertens 2014;32:2285–95.

[34] Collins R, MacMahon S. Blood pressure, antihypertensive drug treatment and the risks of stroke and of coronary heart disease. Br Med Bull 1994;50:272–98

[35] Brunstrom M, Carlberg B. Association of blood pressure lowering with mortality and cardiovascular disease across blood pressure levels: a systematic review and meta-analysis. JAMA Intern Med 2018;178:28–36.

[36] 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). J Hypertens 2013;31:1281–357.

 

Comentarios

Para ver los comentarios de sus colegas o para expresar su opinión debe ingresar con su cuenta de IntraMed.

CONTENIDOS RELACIONADOS
AAIP RNBD
Términos y condiciones de uso | Política de privacidad | Todos los derechos reservados | Copyright 1997-2024