Abnormal Pulsatile Hemodynamics in Hypertensive Patients With Normalized 24‐Hour Ambulatory Blood Pressure by Combination Therapy of Three or More Antihypertensive Agents

Lu, Dai Yin; Li, You; Sung, Shih Hsien; Cheng, Hao Min; Lin, Shing Jong; Chiang, Fu-Tien; Yu, Wen Chung

doi:10.1111/jch.12751

Cited by 4 publications

(4 citation statements)

References 52 publications

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“…Such discrepancies have long been a popular research topic, and whether central BP is a better clinical indicator than brachial BP has also been debated vehemently . In this review, we will address briefly the rationale supporting the clinical use of central BP monitoring …”

Section: Introductionmentioning

confidence: 99%

Central blood pressure for the management of hypertension: Is it a practical clinical tool in current practice?

Cheng

Chuang

Wang

et al. 2019

J of Clinical Hypertension

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Since noninvasive central blood pressure (BP) measuring devices are readily available, central BP has gained growing attention regarding its clinical application in the management of hypertension. The disagreement between central and peripheral BP has long been recognized. Some previous studies showed that noninvasive central BP may be better than the conventional brachial BP in association with target organ damages and long-term cardiovascular outcomes. Recent studies further suggest that the central BP strategy for confirming a diagnosis of hypertension may be more cost-effective than the conventional strategy, and guidance of hypertension management with central BP may result in less use of medications to achieve BP control.Despite the use of central BP being promising, more randomized controlled studies comparing central BP-guided therapeutic strategies with conventional care for cardiovascular events reduction are required because noninvasive central and brachial BP measures are conveniently available. In this brief review, the rationale supporting the utility of central BP in clinical practice and relating challenges are summarized.

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Section: Introductionmentioning

confidence: 99%

Central blood pressure for the management of hypertension: Is it a practical clinical tool in current practice?

Cheng

Chuang

Wang

et al. 2019

J of Clinical Hypertension

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“…Based on data from our previous work [25], the sample size (84 participants per group) was determined on the basis of non-inferiority between three independent groups (α = 0.05; β = 0.20; standard deviation of ambulatory BP 11 mmHg; mean difference and non-inferior margin 5 mmHg, drop rate 10%).…”

Section: Methodsmentioning

confidence: 99%

Guiding Hypertension Management Using Different Blood Pressure Monitoring Strategies (GYMNs study): comparison of three different blood pressure measurement methods: study protocol for a randomized controlled trial

Cheng

Sung

Chen

et al. 2019

Trials

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Background Home blood pressure (BP) and unattended automated BP (uAOBP) monitoring have been recommended by guidelines for the care of hypertensive subjects. However, BP measurements in the peripheral arteries cannot serve as direct substitutes for their central counterparts. Moreover, the comparative effectiveness and safety of BP-guided strategies using these BP measuring devices have never been evaluated. Methods/design Patients with uncontrolled or newly diagnosed hypertension aged 20–90 years will be recruited via outpatient clinics and allocated into three arms by stratified randomization (baseline systolic BP 130–155 mmHg and 155–180 mmHg): home BP, uAOBP, and central BP-guided treatment. At each scheduled visit to the clinic, a patient’s BP will be measured by each of the three methods of measuring BP. The blood pressure from three different methods will be confirmed available at each visit. Patients and physicians will be blinded to the allocated interventions because they will use measured BP values in the clinic through a standardized report format. A common BP target for systolic blood pressure (SBP) of 130 mmHg is adopted for these BP-guided strategies. The primary outcome is the change of 24-h mean ambulatory SBP at 3 months. A key secondary outcome is to determine the percentage achieving their target BPs at 3 months and the decrease of left ventricular mass at 12 months. Discussion To our knowledge, this is the first prospective double-blind randomized controlled trial to assess the optimal guiding strategy for hypertension. It will help to define which BP monitoring method is the most effective for guiding the clinical management of hypertension. It will provide good evidence to support future guideline recommendations for BP monitoring devices. Trial registration ClinicalTrials.gov, NCT03578848 . Registered on 4 June 2018. Electronic supplementary material The online version of this article (10.1186/s13063-019-3366-8) contains supplementary material, which is available to authorized users.

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“…Randomized controlled trials with a variety of interventions designed to investigate the effects on arterial stiffness and hopefully to improve the CV disease outcomes have been summarized in several systematic reviews, such as antihypertensive treatment, 7 body weight reduction, 8 statin, 9 and anti‐diabetic drugs 10 . Therefore, measuring arterial stiffness may not only identify patients at risk at an early stage, but also serve as a surrogate index for treatment monitoring for the effectiveness of therapeutic interventions of interest 2,11,12 …”

Section: The Application Of Arterial Stiffness Measurements In Clinicmentioning

confidence: 99%

Measuring arterial stiffness in clinical practice: Moving one step forward

Cheng¹,

Chen

2020

J of Clinical Hypertension

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Arterial stiffness or arteriosclerosis is the degeneration of the arterial beds, which may be the earliest detectable manifestations of adverse functional and structural changes in the arterial wall. 1 It should be differentiated from atherosclerosis, defined as an occlusive arterial disease characterized by lipid oxidation, inflammation, and plaque formation in the arterial wall. 2 With cumulating evidence, arterial stiffness has been established as an important parameter for the assessment of cardiovascular (CV) risk.

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Abnormal Pulsatile Hemodynamics in Hypertensive Patients With Normalized 24‐Hour Ambulatory Blood Pressure by Combination Therapy of Three or More Antihypertensive Agents

Cited by 4 publications

References 52 publications

Central blood pressure for the management of hypertension: Is it a practical clinical tool in current practice?

Central blood pressure for the management of hypertension: Is it a practical clinical tool in current practice?

Guiding Hypertension Management Using Different Blood Pressure Monitoring Strategies (GYMNs study): comparison of three different blood pressure measurement methods: study protocol for a randomized controlled trial

Measuring arterial stiffness in clinical practice: Moving one step forward

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