Cardiovasculaire Geneeskunde.nl

Hypertension & NICE guideline

Slides (presentatie) - Nov. 7, 2011

Hypertension & NICE guideline: Clinical management of primary hypertension in adults; what is new? 


Prof. Morris Brown – Professor of Clinical Pharmacology,
University of Cambridge, United Kingdom


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Cardiovascular Exchange Summit 2011

Association of hypertension with absolute and relative risk of stroke and MI

Benefits of antihypertensive treatment is proportional to reduction in blood pressure

Benefits of antihypertensive treatment is proportional to reduction in blood pressure

Deciles of Blood Pressure

Deciles of Blood Pressure Variability

Patients with episodic hypertension have a high risk of stroke

Dia 8

ACE-I or ARB beneficial in normotensive atherosclerotic patients

Care pathway

Care pathway

Care pathway

Genetic variants in novel pathways influence blood pressure and cardiovascular disease

Normal Pressure

High Pressure due to Constriction

High PressureDue to Increased Volume

Evidence for two types of hypertension and response to drugs

Comparison of four classes of antihypertensive treatments

Correlations between drug pairs

Two types of hypertension:Type 1 (high-renin, vasoconstrictor)

Two types of drugs for hypertension:Type 1(‘AB’ drugs)

Two types of drugs for hypertension:Type 1(‘AB’ drugs)

Two types of hypertension:Type 2 (low-renin, Na+ dependent)

Two types of hypertension:Type 2 (low-renin, Na+ dependent)

Two types of drugs for hypertension:Type 2 (‘CD’ drugs)

AB/CD Rule for optimisation of antihypertensive treatment


Rationale for study

Effect of Dose and Combination of Antihypertensives on Interindividual Blood Pressure Variability

Rationale for study

Rationale for study

Rationale for study


Cambridge ‘abD’ guideline

Spironolactone as 4th line treatment in ASCOT

Slaying medical myths: Low-dose thiazides are not maximal

Double-blind, dose-ranging crossover comparison of diuretics in low-renin hypertension

Crossover comparison of glucose tolerance on amiloride and HCTZ

The choice of diuretic in hypertension

Summary

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