geoffrey modest medical blogs

  A new Chinese study found that lowering the systolic blood pressure (SBP) to under 120mmHg in patients with high cardiovascular risk was associated with fewer vascular events and only a minor excess in adverse events (see htn BP lower than 120 better ESPRIT study Lancet2024  in dropbox, or doi.org/10.1016/ S0140-6736(24)01028-6)   Details : -- 11,255 hypertensive participants with high cardiovascular risk were enrolled in an open-label, blinded-outcome study from 116 hospitals or communities in China and randomized to a systolic blood pressure target of <120mmHg or <140mmHg from 2019-2020 -- participants were at least 50yo with high cardiovascular risk, defined as established cardiovascular disease or at least 2 major cardiovascular risk factors defined as being at least 60yo for men or 65yo for women, diabetes, dyslipidemia (defined as total cholesterol >200, or LDL >130, or HDL<40), and current smoker (defined as smoking >1 cigarette/day in p...

  hypertension: a personalized approach to meds      You forwarded this message on Mon 5/1/2023 6:33 AM You forwarded this message on Mon 5/1/2023 6:33 AM MG Modest, Geoffrey (HMFP - Medicine)      To:  Modest, Geoffrey (HMFP - Medicine) Mon 5/1/2023 6:32 AM   A very interesting Swedish study just came out suggesting that we should approach hypertension treatment in an individualized way (see  htn variability of response to meds JAMA2022  in dropbox, or  doi:10.1001/jama.2023.3322)    Details :  -- 270 participants in an outpatient research clinic in Uppsala Hospital who were 40-75yo and had systolic blood pressure (SBP) between 140 and 159 mmHg and diastolic < 109 mmHg within five years before the trial,  were randomized in a double-blind repeated crossover trial . All were at low cardiovascular risk   -- 46% female, median age 64, BMI 29, BP at randomization 154/89, ambulatory daytime BP 145/89 -- median of 3 years since ...