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AHA-HBPR: Treating To Lower Blood Pressure Goal Reduces Aortic Stiffness By Peggy Peck Special to DG News ORLANDO, FL -- September 30, 2002 -- Treating non-diabetic hypertensive patients to a target goal of less than 130/85 mm/Hg appears to significantly reduce aortic stiffness, while treating to a goal of less than 140/90 mm/Hg had no effect on aortic stiffness. These findings were reported here Sept. 29 at the American Heart Association’s 56th Annual Fall Conference and Scientific Sessions for High Blood Pressure Research (AHA-HBPR). Senior investigator Atsuhiro Ichihara, MD, PhD, of Keio University School of Medicine in Tokyo, Japan, said the findings suggest that clinicians should treat to "a low target rather than simply treating to a goal of less than 140/90 mm/Hg." Over the course of a year average PWV in the low-target blood pressure group decreased to 1,621 plus or minus 34 cm/s compared to 1,779 plus or minus 41 cm/s at baseline, but there was no significant decrease in the patients treated to traditional goals. "This indicates that treating to these lower targets can reduce aortic stiffness," Dr. Ichihara said. Dr. Ernesto Schiffrin, who chaired the program committee at the conference, said that Dr. Ichihara’s findings follow a general trend toward treating to "lower pressures in recent years and several studies have demonstrated a benefit for really low target pressures." He said he and other researchers expect the next set of recommendations from the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC) to call for lower treatment goals. Those recommendations, JNC-VII, will probably be issued next year, he said. Dr. Ichihara studied 142 non-diabetic patients with hypertension. The mean age was 67.7 years, and 65 were male. Average blood pressure at baseline was 177 plus or minus 1 over 101 plus or minus 1 mm/Hg. Every three months, aortic stiffness was assessed from the measurement of heart-tibial PWV using pulse pressure analyser (ABI form, Nihon Colin). Seventy-one patients were randomised to the low-target blood pressure group (<130/85 mm/Hg) and 71 to a target of <140/90 mm/Hg. The anti-hypertensive drugs included calcium channel blockers (110 patients), angiotensin-converting enzyme (ACE) inhibitors (53 patients), angiotensin-receptor blockers (ARBs) (19 patients), alpha-blockers (21 patients), beta-blockers (22 patients), and diuretics (9 patients), either alone or in combination. Twenty-six patients were smokers, and 48 patients were medically treated for dyslipidemia. During the 12-month follow-up, systolic blood pressure (SBP)/diastolic blood pressure (DBP) significantly decreased to 129 plus or minus 1 over 78 plus or minus 1 mm/Hg in the low target group and 153 plus or minus 2 over 86 plus or minus 1 mm/Hg in the standard target group. Between the two groups, there was no significant difference in kinds of anti-hypertensive drugs, ankle brachial index, or serum levels of lipids, creatinin, and C-reactive protein. E-mail this page to a friend or colleague! To print, use this version