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Intensive blood pressure lowering: a practical review

Clinical Hypertension 2020년 26권 1호 p.21 ~ 21
Camafort Miguel, Redon Josep, 편욱범, Coca Antonio,
소속 상세정보
 ( Camafort Miguel ) - University of Barcelona Department of Internal Medicine
 ( Redon Josep ) - Instituto de Salud Carlos III Ciber-OBN
편욱범 ( Pyun Wook-Bum ) - Ewha Womans University School of Medicine Department of Internal Medicine
 ( Coca Antonio ) - University of Barcelona Department of Internal Medicine

Abstract


According to the last Hypertension guideline recommendations, it may be concluded that intensive BP lowering is only advisable in a subgroup of patients where there is a clear net benefit of targeting to lower BP goals. However, taking into account the relevance of correct BP measurement, estimates of the benefits versus the harm should be based on reliable office BP measurements and home BP measurements. There is still debate about which BP goals are optimal in reducing morbidity and mortality in uncomplicated hypertensives and in those with associated comorbidities. In recent years, trials and meta-analyses have assessed intensive BP lowering, with some success. However, a careful examination of the results shows that current data are not easily applicable to the general hypertensive population. This article reviews the evidence on and controversies about intensive BP lowering in general and in specific clinical situations, and the importance of obtaining reliable BP readings in patients with hypertension and comorbidities.

키워드

Intensive blood pressure lowering; Ageing; Obesity, cardiovascular risk; Diabetes mellitus type 2; Ischemic heart disease; Chronic kidney disease; Heart failure; Ambulatory blood pressure measurement

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