title: Hitting the mark: blood pressure targets and agents in those with prevalent cardiovascular disease and heart failure.
abstract: Blood pressure (BP) is one of the key modifiable risk factors for cardiovascular disease (CVD) both in primary and secondary prevention of disease. In this review, we discuss BP treatment in prevalent CVD and heart failure. Evidence for specific agents based on their neurohormonal effects and evidence for target values for systolic or diastolic BP are covered. The potential adverse effects of overtreatment of BP are also discussed. BP targets for those with CVD should generally be less than 140/90 mm Hg but require individualization of therapy for any further reduction based on the clinical setting.
authors.affiliation: Division of Nephrology, Veterans' Affairs Healthcare System, San Diego, CA and University of California, San Diego, CA; Division of Cardiology, Tufts Medical Center, Boston, MA; and Division of Nephrology, Tufts Medical Center, Boston, MA.
authors.forename: Dena E
authors.initials: DE
authors.lastname: Rifkin
authors.affiliation: Division of Nephrology, Veterans' Affairs Healthcare System, San Diego, CA and University of California, San Diego, CA; Division of Cardiology, Tufts Medical Center, Boston, MA; and Division of Nephrology, Tufts Medical Center, Boston, MA.
authors.forename: Michael
authors.initials: M
authors.lastname: Kiernan
authors.affiliation: Division of Nephrology, Veterans' Affairs Healthcare System, San Diego, CA and University of California, San Diego, CA; Division of Cardiology, Tufts Medical Center, Boston, MA; and Division of Nephrology, Tufts Medical Center, Boston, MA. Electronic address: msarnak@tuftsmedicalcenter.org.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Sarnak
mesh_terms: D000959:Antihypertensive Agents / Q000493:pharmacokinetics / Q000627:therapeutic use; D001682:Biological Availability; D001794:Blood Pressure / Q000187:drug effects*; D001795:Blood Pressure Determination; D003324:Coronary Artery Disease / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D006333:Heart Failure / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D012307:Risk Factors
chemical_list: D000959:Antihypertensive Agents
keywords: Atherosclerosis; Blood pressure; Blood pressure medications; Heart failure