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Arterial hypertension – Clinical trials update 2021
Institution:Klinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Saarland University, Homburg, Germany
Abstract:AimThis review aims to summarize and discuss some of the most relevant clinical trials in epidemiology, diagnostics, and treatment of hypertension published in 2020 and 2021.Data synthesisThe trials included in this review are related to hypertension onset age and risk for future cardiovascular disease, reliability of different blood pressure monitoring methods, role of exercise-induced hypertension, treatment of hypertension in patients with SARS-CoV-2 infection, management of hypertension high-risk patient groups, e.g., in the elderly (≥80 years) and patients with atrial fibrillation, and the interplay between nutrition and hypertension, as well as recent insights into renal denervation for treatment of hypertension.ConclusionsHypertension onset age, nighttime blood pressure levels and a riser pattern are relevant for the prognosis of future cardiovascular diseases. The risk of coronary heart disease appears to increase linearly with increasing exercise systolic blood pressure. Renin-angiotensin system blockers are not associated with an increased risk for a severe course of COVID-19. In elderly patients, a risk-benefit assessment of intensified blood pressure control should be individually evaluated. A J-shaped association between cardiovascular disease and achieved blood pressure could also be demonstrated in patients with atrial fibrillation on anticoagulation. Salt restriction and lifestyle modification remain effective options in treating hypertensive patients at low cardiovascular risk. Sodium glucose co-transporter 2 inhibitors and Glucagon-like peptide-1 receptor agonists show BP-lowering effects. Renal denervation should be considered as an additional or alternative treatment option in selected patients with uncontrolled hypertension.
Keywords:Arterial hypertension  Cardiovascular risk  Exercise-induced hypertension  COVID-19  Renal denervation  ABP"}  {"#name":"keyword"  "$":{"id":"kwrd0040"}  "$$":[{"#name":"text"  "_":"ambulatory blood pressure  ABPM"}  {"#name":"keyword"  "$":{"id":"kwrd0050"}  "$$":[{"#name":"text"  "_":"ambulatory blood pressure monitoring  ACE2"}  {"#name":"keyword"  "$":{"id":"kwrd0060"}  "$$":[{"#name":"text"  "_":"angiotensin-converting enzyme-2  ACE-I"}  {"#name":"keyword"  "$":{"id":"kwrd0070"}  "$$":[{"#name":"text"  "_":"Angiotensin-converting enzyme inhibitors  AF"}  {"#name":"keyword"  "$":{"id":"kwrd0080"}  "$$":[{"#name":"text"  "_":"atrial fibrillation  aHR"}  {"#name":"keyword"  "$":{"id":"kwrd0090"}  "$$":[{"#name":"text"  "_":"adjusted hazard ratio  ARBs"}  {"#name":"keyword"  "$":{"id":"kwrd0100"}  "$$":[{"#name":"text"  "_":"angiotensin receptor blockers  BP"}  {"#name":"keyword"  "$":{"id":"kwrd0110"}  "$$":[{"#name":"text"  "_":"blood pressure  CI"}  {"#name":"keyword"  "$":{"id":"kwrd0120"}  "$$":[{"#name":"text"  "_":"confidence interval  COVID-19"}  {"#name":"keyword"  "$":{"id":"kwrd0130"}  "$$":[{"#name":"text"  "_":"coronavirus disease 2019  CVD"}  {"#name":"keyword"  "$":{"id":"kwrd0140"}  "$$":[{"#name":"text"  "_":"cardiovascular diseases  DASH"}  {"#name":"keyword"  "$":{"id":"kwrd0150"}  "$$":[{"#name":"text"  "_":"dietary approaches to stop hypertension  GLP1-RA"}  {"#name":"keyword"  "$":{"id":"kwrd0160"}  "$$":[{"#name":"text"  "_":"Glucagon-like peptide-1 receptor agonists  HBP"}  {"#name":"keyword"  "$":{"id":"kwrd0170"}  "$$":[{"#name":"text"  "_":"home blood pressure  HBPM"}  {"#name":"keyword"  "$":{"id":"kwrd0180"}  "$$":[{"#name":"text"  "_":"home blood pressure monitoring  HR"}  {"#name":"keyword"  "$":{"id":"kwrd0190"}  "$$":[{"#name":"text"  "_":"hazard ratio  LVMI"}  {"#name":"keyword"  "$":{"id":"kwrd0200"}  "$$":[{"#name":"text"  "_":"left ventricular mass index  OBP"}  {"#name":"keyword"  "$":{"id":"kwrd0210"}  "$$":[{"#name":"text"  "_":"office blood pressure  RAS"}  {"#name":"keyword"  "$":{"id":"kwrd0220"}  "$$":[{"#name":"text"  "_":"renin-angiotensin system  T2DM"}  {"#name":"keyword"  "$":{"id":"kwrd0230"}  "$$":[{"#name":"text"  "_":"diabetes mellitus type 2  SARS-CoV-2"}  {"#name":"keyword"  "$":{"id":"kwrd0240"}  "$$":[{"#name":"text"  "_":"severe acute respiratory syndrome coronavirus type 2  SBP"}  {"#name":"keyword"  "$":{"id":"kwrd0250"}  "$$":[{"#name":"text"  "_":"systolic blood pressure  SGLT-2"}  {"#name":"keyword"  "$":{"id":"kwrd0260"}  "$$":[{"#name":"text"  "_":"Sodium glucose co-transporter 2  24-h"}  {"#name":"keyword"  "$":{"id":"kwrd0250a"}  "$$":[{"#name":"text"  "_":"24-hour  RDN"}  {"#name":"keyword"  "$":{"id":"kwrd0270"}  "$$":[{"#name":"text"  "_":"renal denervation  W"}  {"#name":"keyword"  "$":{"id":"kwrd0280"}  "$$":[{"#name":"text"  "_":"Watt
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