Key result
Modest systolic blood pressure reductions to 160-180 mm Hg led to a striking resolution of vascular and glomerular malignant nephrosclerosis injury (injury score 35 vs 9, P<0.0001).
Why the study?
Does blood pressure reduction below a critical threshold prevent and repair malignant nephrosclerosis in stroke-prone spontaneously hypertensive rats?
Population
Stroke-prone spontaneously hypertensive rats receiving 1% NaCl as drinking fluid for 4 weeks
Comparison
Antihypertensive therapy to maintain final… vs Untreated stroke-prone spontaneously…
Design
Preclinical
Follow-up
4 to 7 weeks
Authors
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Should not yet alter BP targets in malignant hypertension; leaves open translation of reversible nephrosclerosis from rat models to patients.
Does blood pressure reduction below a critical threshold prevent and repair malignant nephrosclerosis in stroke-prone spontaneously hypertensive rats?
Absolute Event Rate: 9% vs 35%
p-value: p=<0.0001
Lowering blood pressure below a critical threshold prevents and rapidly repairs malignant nephrosclerosis in a hypertensive rat model, regardless of the antihypertensive class used.
Griffin et al. (2014) studied Malignant nephrosclerosis and severe hypertension (n=97). Antihypertensive therapy (enalapril, amlodipine, or hydralazine/hydrochlorothiazide) vs. Untreated / Pre-therapy baseline was evaluated on Histological damage score (p=<0.0001). Modest systolic blood pressure reductions to 160-180 mm Hg led to a striking resolution of vascular and glomerular malignant nephrosclerosis injury (injury score 35 vs 9, P<0.0001).
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