Evidence base: Hypertension

A summary of the evidence behind the diagnostic criteria and management of hypertension

Hypertension is often identified incidentally (SPL)
Hypertension is often identified incidentally (SPL)
  • Czernichow S, Zanchetti A, Turnbull F et al. Blood Pressure Lowering Treatment Trialists' Collaboration. The effects of BP reduction and of different blood pressure-lowering regimens on major cardiovascular events according to baseline blood pressure: meta-analysis of randomized trials. J Hypertens 2011; 29: 4-16.

This paper pulls together the results of 32 trials showing that the effectiveness of BP lowering in prevention of cardiovascular events does not depend on starting BP and that additional efforts in those meeting existing targets will produce further benefits.

  • Kotseva K, Wood D, De Backer G et al; the Euroaspire Study Group. Euroaspire III. Management of cardiovascular risk factors in asymptomatic high-risk patients in general practice: cross-sectional survey in 12 European countries. Eur J Cardiovasc Prev and Rehab 2010; 17: 530-40.

These data come from a survey of 66 general practices in 12 European countries suggesting that BP remains poorly diagnosed and controlled, lipid and glucose control are inadequate and that lifestyle issues also remain a cause for concern with a high prevalence of persistent smoking and obesity.

This was a study in more than 24,000 patients demonstrating equivalence between telmisartan (an ARB) and ramipril (an ACE inhibitor) for cardiovascular outcomes. The combination of an ARB with an ACE inhibitor in this study was of no additional benefit but was associated with more side-effects.

Guidelines

Curriculum

Contributed by Dr Klaus Witte, senior lecturer and honorary consultant cardiologist, University of Leeds and Leeds General Infirmary

 

 

 

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins

Register

Already registered?

Sign in

Follow Us:

Just published

'How I survived a bewildering ten-month investigation by the GMC'

'How I survived a bewildering ten-month investigation by the GMC'

How does the experience of a GMC investigation impact on the lives of doctors? One...

90% of patients would recommend their GP practice to friends or family

90% of patients would recommend their GP practice to friends or family

Nine in 10 people would recommend their GP practice to a friend or family member,...

NHS documentary spells out threat to future of the health service

NHS documentary spells out threat to future of the health service

A documentary film appearing in cinemas across the UK next month tells how the NHS...

GP funding rose much faster in rest of UK than England in 2018/19

GP funding rose much faster in rest of UK than England in 2018/19

Total NHS investment in general practice in England rose just 1.36% in real terms...

GP funding per patient rose less than 1% in 2018/19

GP funding per patient rose less than 1% in 2018/19

GP funding per patient in England rose to £154.81 in 2018/19 - up just 0.7% from...

Temporary cap extended on GP at Hand registrations in Birmingham

Temporary cap extended on GP at Hand registrations in Birmingham

A temporary cap on patients in Birmingham registering with Babylon GP at Hand has...