The re-analysis continued to show significant reductions in SBP and DBP for spironolactone compared with placebo (SBP: WMD = -10.8 mm Hg
; 95% CI, -13.16 to -8.43 mm Hg
; DBP: WMD = -4.62 mm Hg
; 95% CI, -6.05 to -3.2 mm Hg
; [I.sup.2] = 35%), confirming that the excluded trial was the source of heterogeneity in the initial analysis and that spironolactone continued to significantly lower BP for the treatment group compared with controls.
The new study analyzed outcome according to four baseline SBP categories: 120/129, 130/139, 140/149, and 150/159 mm Hg
"These findings are important because a drop in blood pressure as small as 2 mm Hg
can reduce the risk of cardiovascular events such as heart attack by up to 10 per cent.
By week 8, the mean systolic blood pressure (SBP) had fallen by 9.7 mm Hg
from a baseline of 153.9, which in hypertension circles is deemed a clinically meaningful improvement.
Further pressure reductions to less than 130/80 mm Hg
are usually harder, the incremental benefit from further reduction is less than when pressures first fall below 140/90 mm Hg
, and the evidence for incremental benefit of any size from further pressure reduction is less strong for certain key patient subgroups: people at least 80 years old, and patients with diabetes, chronic kidney disease, or coronary artery disease, said Dr.
* Elevated BP: SBP 120-129 mm Hg
and DBP <80 mm Hg
The handgrip induced SBP changes observed in the female cases at 1 min (145.8 [+ or -] 2.84 mm Hg
), 3 min (147.6 [+ or -] 2.74 mm Hg
) and 5 min (144.0 [+ or -] 1.83 mm Hg
) were significantly different than the female controls at 1 min (136.3 [+ or -] 1.03 mm Hg
), 3 min (136.4 [+ or -] 0.99 mm Hg
) and 5 min (137.3 [+ or -] 1.12 mm Hg
Additionally, in this trial of more than 9,000 patients with hypertension, those who were able to achieve a blood pressure below 120 mm Hg
had a 43 percent lower risk of cardiovascular death and a 27 percent lower risk of death from any cause than patients whose target systolic blood pressure was 140 mm Hg
Similarly, MADs were associated with a significant 2.1 mm Hg
reduction in systolic pressure and 1.9 mm-Hg reduction in diastolic pressure, compared with inactive controls.
Out of 25, most of the patients 13 (52%) had IOP in the range of 21-30mm Hg, and 5 (20%) had an IOP of 10-20mm Hg, 4 (16%) patients had IOP in the range of 31-40mm Hg, 2 (8%) patients presented with 41-50 mm Hg
. 1 (4%) patient had an IOP of above 50 mm Hg
Mean blood pressure measurements taken at the three locations varied greatly, affecting diagnosis and clinical decision-making: "The proportion of patients who had control of his or her SBP in the first 30 days (<140 mm Hg
for clinic or research measurement; <135 mm Hg
for home measurement) differed between method of measurement: 28% were in control according to clinic measurement, 47% were in control according to home measurement, and 68% were in control according to research measurement." Overall, mean home systolic blood pressure (SBP) was 9.6 mm Hg
less than mean clinical measurement.
Compared to baseline, in the CGJ group systolic BP was reduced on average by 7.2 mm Hg
(p = 0.005) and diastolic BP was reduced on average by 6.2 mm Hg
(p = 0.001) at the end of 8 weeks.