31. All-cause mortality, CVD, and cancer mortality were highest in the low-DBP group (<75 mm Hg). Thus, comorbidities such as cancer and thus low weight and hypotension were the confounding factors that obscured the true relationship of BP and mortality.
35. 0
80
85
90
95
100
105
0
3
6
12
24
36
Final follow-up
74%
43%
DBP
mm Hg
target 80 mm Hg
86%
73%
55%
target 85 mm Hg
target 90 mm Hg
HOT - Target blood pressure is an achievable goal (% patients reaching target)
60%
Hansson et al 1998
Months
36. Risk of a major cardiovascular event reduced by 30% in the HOT Study
0
5
10
15
20
25
30
105
100
95
90
85
% risk reduction
Optimal DBP reduction in the HOT Study
Hansson et al 1998
Achieved DBP mm Hg
80
37.
38.
39.
40.
41.
42.
43.
44. Vaccarino V, Holford TR, Krumholz HM. Pulse pressure and risk for myocardial infarction
and heart failure in the elderly. J Am Coll Cardiol 2000;36:130–8.
45.
46.
47.
48.
49.
50.
51.
52. 1.LA CURVA J ESTA PRESENTE EN MUCHOS ESTUDIOS DE HIPERTENSION ARTERIAL RELACIONANDO MORTALIDAD CARDOVASCULAR CON PRESION DIASTOLICA 2. LA CURVA J ES MAS COMUN EN PACIENTES CON ENFERMEDAD ATEROSCLEROTICA AVANZADA 3. LA CAUSA DE ESTA CURVA ES AUN CONTROVERSIAL PORQUE LOS ESTUDIOS NO HAN SIDO DISEÑADOS EXPRESAMENTE PARA ESTUDIAR ESTA RELACION
4.DEBE BUSCARSE REDUCIR LA PRESION SISTOLICA DEBAJO DE 140 mmHg Y LA DIASTOLICA DEBAJO DE 90 mmHg EN LOS PACIENTES DE ALTO RIESGO SIN IR “ MAS BAJO MEJOR”