EDITORIAL

Relation between blood pressure after an acute coronary event and subsequent cardiovascular risk

C-K Wong, H D White

Cardiovascular Research Unit, Green Lane Hospital, Auckland, New Zealand

Correspondence to:
Professor Harvey White, Cardiology Department, Green Lane Hospital, Private Bag 92–189, Auckland 1030, New Zealand;
harveyw@adhb.govt.nz

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Evidence is accumulating that after an acute coronary event, assiduous control of both systolic and diastolic pressure is indicated

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Keywords: blood pressure; acute coronary events; cardiovascular risk

Abbreviations: ACE, angiotensin converting enzyme; EUROASPIRE, European action on secondary and primary prevention through intervention to reduce events; EUROPA, European trial on reduction of cardiac events with perindopril in stable coronary artery disease; GUSTO, global use of strategies to open occluded coronary arteries; HOPE, heart outcomes prevention evaluation; HOT, hypertension optimal treatment; LIPID, long-term intervention with pravastatin in ischemic disease; PAMELA, pressioni arteriose monitorate e loro associazioni; PEACE, prevention of events with angiotensin-converting enzyme inhibition; PREVENIR, distribution and treatment of cardiovascular risk factors in coronary patients; QUIET, quinapril ischemic event trial; SAVE, survival and ventricular enlargement; TIMI, thrombolysis in myocardial infarction

The first 150 words of the full text of this article appear below.

Concepts about the relation between blood pressure and outcomes have evolved over the last 20 years from a sole emphasis on diastolic blood pressure to include both systolic blood pressure¹ and pulse pressure.^2,3 Recently the Framingham heart study has provided further longitudinal data on the natural evolution of blood pressure over a person’s lifetime.⁴ The systolic pressure rises linearly between the ages of 30 and 84 years. There is initially a concurrent increase in the diastolic pressure, but between the ages of 50 and 60 years the diastolic pressure begins to decline and the pulse pressure widens steeply.⁴ It has also been shown that in young subjects the brachial systolic pressure is higher than the central aortic systolic pressure, whereas in older subjects (> 60 years) this difference disappears.⁵ The explanation for these findings is that there is an age related increase in stiffness accompanied by decreases in the elasticity . . . [Full text of this article]

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QUIET about HOPE

Eric Q Klug

Online, 5 Dec 2002 [Full text]

Authors' reply

Harvey D. White, et al.

Online, 5 Dec 2002 [Full text]