Friday, May 8, 2015

New recommendations for treating patients with high blood pressure and cardiovascular disease

Scientific Statement"

March 31, 2015 Categories: Heart NewsScientific Statements/Guidelines



Statement Highlights
  • Three professional organizations have issued a joint statement on treating high blood pressure in people who have been diagnosed with coronary heart disease, stroke or other forms of heart disease.
  • The statement reinforces the goal of reducing blood pressure to under 140/90 in order to reduce the risk of heart attack and stroke.
  • Patients should know their blood pressure, make lifestyle changes to reduce their risk of heart attack and stroke, and work with a physician to safely lower their blood pressure.
This article was published in DALLAS, Texas on  March 31, 2015 .  The American Heart Association came out and discussed a new scientific statement issued jointly by three medical organizations and published in the American Heart Association’s journal Hypertension, which addresses how low healthcare providers should target the blood pressure when treating patients with high blood pressure who also have vascular diseases."The document provides an up-to-date summary on treating hypertension in patients who have both high blood pressure and have had a strokeheart attack or some other forms of heart disease, said Elliott Antman, M.D., President of the American Heart Association and professor of medicine at Harvard Medical School."1

In the article; “The writing committee reinforces the target of less than 140/90 to prevent heart attacks and strokes in patients with hypertension and coronary artery disease,” he said. “This is important since confusion has arisen in the clinical community over the last year regarding the appropriate target for blood pressure management in the general population.”1
The American Heart Association, American College of Cardiology, and American Society of Hypertension have 
issued a joint statement regarding this issue. 
According to this joint statement, "while a target of less than 140/90 is reasonable to avoid heart attacks and strokes, a lower target of less than 130/80 may be appropriate in some individuals with heart disease who have already experienced a stroke, heart attack, or mini-stroke (also called a transient ischemic attack or TIA) or who have other cardiovascular conditions such as a narrowing of leg arteries or abdominal aortic aneurysm."1
The committee states that lowering  a patient's b
lood-pressure can be done safely, and the vast majority of individuals will not experience problems when standard medications are administered correctly. However, the joint statement recommends that healthcare providers use extreme caution in patients with coronary artery blockages, advising that "blood pressure should be lowered slowly, and not strive to decrease the diastolic (lower number) blood pressure to less than 60 mm Hg, particularly in patients more than 60 years old."
The group writing the article and recommendations offer specific, evidence-based recommendations and contraindications to help healthcare providers select which 
anti-hypertensive medications to use in patients with various types of heart disease. 

“In the spectrum of drugs available for the treatment of hypertension, beta-blockers assume center stage in patients with coronary artery disease,” said Clive Rosendorff, M.D., Ph.D., who is the chair of the writing committee, as well as a professor of medicine at the Icahn School of Medicine at Mount Sinai in New York.  He is also the director of graduate medical education at the Veterans Administration in the Bronx.   Beta-blockers not only slow the heart rate and reduce the force of cardiac contraction, both of which reduce the heart’s consumption of oxygen. They also increase blood flow to the heart by prolonging the time between contractions, which is when blood flows into the heart muscle.


Additional Resources:
References
  1.  Association, A. (2015, March 31). New recommendations for treating patients with high blood pressure and cardiovascular disease. Retrieved May 8, 2015, from http://newsroom.heart.org/news/new-recommendations-for-treating-patients-with-high-blood-pressure-and-cardiovascular-disease