We are well aware of the multifactorial nature of hypertension, as well as the fact that it responds well to medication and lifestyle changes. It can be treated with renal denervation (RDN), which has been shown safe and effective in several randomized and non-randomized studies. However, the group of patients that will benefit most from…
Hypertensive Patients: Maximizing Doses or Adding New Drugs
Adding new medication in moderate doses to control hypertension conveniently maximizes efficacy, reduces adverse effects and minimizes costs, among other advantages. On the flipside, patients having to remember a whole list of drugs and their combination will often lead to non-adherence or forgetfulness. The latter has been shown not only by dedicated trials, but also…
ESC 2021 | STEP: Blood Pressure Values in the Elderly, A Never-Ending Debate
The results of the STEP study were presented at the European Society of Cardiology (ESC) 2021 Congress! The main finding from this research was that an ideal target of 110 mmHg or at least <130 mmHg blood pressure (compared with a target of 130 mmHg or at least 150 mmHg) yielded an absolute risk reduction of composite events of…
Diastolic Pressure Could Play a Dirty Trick on Patients Treated for Hypertension
Having too low diastolic pressure could be linked to an increase in cardiovascular events (J-shape phenomenon). However, current guidelines suggest a target blood pressure under 130/80 mmHg with no lower limit for diastolic pressure. This paper, recently published in JAMA, sought to evaluate the J-shape phenomenon of diastolic pressure in treated patients who reached a target…
EuroPCR 2020 | Is Renal Denervation Coming Back to Life?
Additional analyses from the Global SYMPLICITY Registry and the RADIANCE-HTN SOLO trial, presented virtually at EuroPCR 2020, can contribute to the comeback of renal denervation as another alternative for patients with uncontrolled hypertension. The 3-year results from the SYMPLICITY registry showed significant and durable reductions in blood pressure regardless of how many medications patients were taking.…
Blood Pressure Variability and Subclinical Brain Disease
Elevated blood pressure variability was associated with a wide range of subclinical structural changes in the brain. These structural changes could be the mechanisms explaining a higher incidence of dementia and stroke. This study included 2348 participants age ≥55 years in a prospective cohort. Blood pressure was measured in each visit since 1990, and since 2005 all…
Virtual ACC 2020 | More Evidence in Support of the Demanding 2017 Hypertension Guidelines
It’s been a while since the demanding and tough 2017 document written jointly between ACC and AHA where, with much controversy, cutoff hypertension values were taken to extreme limits. In fact, more flexible ESC guidelines came out a few months later. Despite this document, hypertension-related cardiovascular death kept increasing in the US across all age…
What is Optimal Blood Pressure?
In the last 30 years, the clinical practice guidelines on both sides of the Atlantic have been lowering blood pressure thresholds. From the starting 160 mmHg systolic blood pressure to 130 mmHg or even 120 mmHg. In 2017, the American and the ACC/AHA guidelines were the first to lower said threshold, followed by the European…
SYMPLICITY Registry: Renal Denervation Struggles Not to Be Forgotten
Long-term data from this registry account for the largest cohort of hypertensive patients who received renal denervation in a real-world clinical setting. This study, recently published by the European Heart Journal, confirms both the safety and efficacy of the procedure with significant and sustained reductions in both office and ambulatory blood pressure. The Global SYMPLICITY…
ESC 2019 | HOPE 4: Overcoming Obstacles to Treat Risk Factors in Developing Countries
Exhaustive intervention carried out by healthcare non-medical healthcare professionals with the support of community members resulted in a significant reduction of systolic blood pressure, LDL cholesterol levels and CAD risk in patients of Malaysia and Colombia, according to this study presented at ESC 2019 in Paris and simultaneously published in Lancet. This intervention translated into…
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