Journal of hypertension
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Journal of hypertension · Nov 2017
Meta AnalysisEffects of blood-pressure-lowering treatment on outcome incidence in hypertension. 11. Effects of total cardiovascular risk and achieved blood pressure: overview and meta-analyses of randomized trials.
In recent meta-analyses of blood pressure (BP)-lowering randomized controlled trials (RCTs), we have shown that in hypertensive patients with diabetes, but not in those without, relative risk reduction of cardiovascular outcomes for a standardized BP reduction is significantly smaller at progressively lower SBP values achieved by treatment. ⋯ A high level of cardiovascular risk is not in itself a restraint to target at SBP values less than 130 mmHg, if treatment is well tolerated. Though a high cardiovascular risk associated with diabetes is not an indication for aiming at SBP less than 130 mmHg, current evidence is that SBP values slightly below 130 mmHg are not associated with harm.
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Journal of hypertension · Nov 2017
ReviewIn-utero exposure to antihypertensive medication and neonatal and child health outcomes: a systematic review.
Although medication is generally avoided wherever possible during pregnancy, pharmacotherapy is required for the treatment of pregnancy associated hypertension, which remains a leading cause of maternal and fetal morbidity and mortality. The long-term effects to the child of in-utero exposure to antihypertensive agents remains largely unknown. ⋯ The current systematic review demonstrates a paucity of relevant published high-quality studies. A small number of studies suggest possible increased risk of adverse child health outcomes; however, most published studies have methodological weaknesses and/or lacked statistical power thus preventing any firm conclusions being drawn.