What is the clinical evidence from this study?

Study design: Review. Population: Hypertension and cardiovascular disease. Intervention: Cardiovascular risk factors.

What question did this study set out to answer?

To review the relationship between blood pressure, coexisting cardiovascular risk factors, and target organ damage in determining the indications for antihypertensive treatment.

April 21, 2001BMJOpen Access

Cardiovascular risk factors and their effects on the decision to treat hypertension: evidence based review

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Key result

Hypertension increases cardiovascular risk two to three times, and the decision to treat should be based on a patient's absolute cardiovascular risk calculated from multiple risk factors.

Design

Review

Authors

RPRaj PadwalPreventive Cardiology

Discussion

Member takes

Implication

Supports absolute-risk thresholds for hypertension treatment; leaves open validation in contemporary diverse cohorts.

Key Points

To review the relationship between blood pressure, coexisting cardiovascular risk factors, and target organ damage in determining the indications for antihypertensive treatment.
Synthesized findings from large population-based cohort studies and randomized clinical trials evaluating blood pressure distributions and cardiovascular outcomes.
Examined international guideline definitions of hypertension and cardiovascular risk prediction models.
Cardiovascular disease risk displays a continuous, strong, and graded relationship with blood pressure, lacking a discrete threshold value that reliably predicts future events.
Hypertension elevates relative risk of cardiovascular and atherosclerotic outcomes approximately two- to threefold across diverse clinical subgroups.
Overall risk is multiplied by concurrent factors including advanced age, male sex, smoking, diabetes mellitus, hypercholesterolemia, and left ventricular hypertrophy, but is partially reversible with treatment.

PICO

Population

Hypertension and cardiovascular disease

Exposure / Comparator

Cardiovascular risk factors

The decision to treat hypertension should be based on a patient's absolute cardiovascular risk, calculated using established risk prediction models, rather than blood pressure levels alone.

Limitations

Framingham risk equations may overestimate risk in populations outside northern Europe and the United States.
Evidence supporting independent causal effects for newer potentially modifiable cardiovascular risk factors is conflicting and weak.
Many risk prediction models have not been independently validated in women or other populations.

Cite This Study

Raj Padwal (2001) conducted a review in Hypertension and cardiovascular disease. Cardiovascular risk factors was evaluated. Hypertension increases cardiovascular risk two to three times, and the decision to treat should be based on a patient's absolute cardiovascular risk calculated from multiple risk factors.

synapsesocial.com/papers/6a99b5111501ecb4bce2740a https://doi.org/10.1136/bmj.322.7292.977

Topics

Hypertension management Women and heart disease Cardiovascular prevention

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