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News from Dec. 23, 2014, Annals of Internal Medicine

December 22, 2014

1. Blood pressure drugs likely to prevent stroke and death in patients with mild hypertension

Pharmacologic blood pressure reduction may prevent major cardiovascular events and death in patients with mild, or stage 1 hypertension (systolic blood pressure of 140 to 159 mm Hg and/or diastolic blood pressure of 90 to 99 mm Hg), according to a systematic review published in Annals of Internal Medicine. Having elevated blood pressure is the leading cause of premature death globally and the number of persons with clinically abnormal blood pressure is increasing. Most of these patients have mild hypertension and no overt cardiovascular disease and the effects of pharmacologic blood pressure reduction in this group are unclear. Researchers conducted a systematic review of published evidence to determine whether pharmacologic blood pressure reduction prevents cardiovascular events and deaths in persons with mild hypertension. They found that blood pressure-lowering therapy tended to lead to reductions in stroke, cardiovascular deaths, and total deaths.

Note: The URL for this story will be live when embargo lifts. For a PDF, please contact Megan Hanks. To interview Dr. Johan Sundström, please contact Maria Åslund at maria.aslund@ucr.uu.se or +46 18 611 95 44.




2. Task force reviews evidence to update blood pressure screening recommendations

Ambulatory monitoring may improve the diagnostic accuracy of office screening

Repeated measurements taken outside of a medical setting by ambulatory blood pressure monitoring may improve the diagnostic accuracy of blood pressure screening conducted in a clinical setting, according to an evidence review published in Annals of Internal Medicine. Nearly one in three U.S. adults has high blood pressure, the leading risk factor for premature death. Previous evidence reviews have shown that treatment of adults with high blood pressure can reduce cardiovascular disease events. Researchers for the U.S. Preventive Services Task Force (USPSTF) reviewed published studies to update a systematic review on the benefits and harms of screening for high blood pressure in adults. The researchers also summarized evidence on rescreening intervals and diagnostic and predictive accuracy of different blood pressure screening methods for cardiovascular events. Ambulatory blood pressure monitoring should be considered a reference standard for confirming elevated office blood pressure screening results to avoid misdiagnosis and overtreatment, unless immediate treatment is required. In addition, the review suggests that certain high-risk people should be screened more often than those without risk factors, and that there is a need for improving the accuracy of blood pressure measurement in the clinic. A draft recommendation statement will be posted for public comment at the USPSTF web site at http://www.uspreventiveservicestaskforce.org when the embargo lifts.

Note: The URL will be live when the embargo lifts. For a PDF, please contact Megan Hanks. To interview the author of the evidence review, please contact Mary Sawyers at mary.a.sawyers@kpchr.org. To interview a member of the Task Force, please contact Ana Fullmer or Nicole Raisch at newsroom@uspstf.net.
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American College of Physicians

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