Grant: Rapid Funding for DSEN Targeted Research

Blood pressure is a measure of the pressure which blood places against the walls of blood vessels during circulation. It is typically measured using two numbers, systolic blood pressure (SBP) and diastolic blood pressure (DSP). When SBP rises above 140mmHg or DSP rises above 90mmHg, the patient is considered to have hypertension. Hypertension is a chronic condition which places increased stress on the heart for circulation of blood, and it has been documented as a critical risk factor for significant events including heart attack, heart failure, stroke, peripheral artery disease, and death. Hypertension has been cited as the most common attributable risk factor for death worldwide, and an independent predictor of stroke mortality and ischemic heart disease mortality. Reduction of elevated blood pressure is associated with a proportional reduction of patients' risks of clinically significant events such as those noted above. In addition to lifestyle changes (exercise, weight reduction, dietary changes, etc), antihypertensive pharmacotherapies can be prescribed by clinicians to help manage high blood pressure. These include the classes of diuretics, angiotensin-converting enzyme inhibitors, calcium channel blockers, beta blockers, alpha blockers, and angiotensin receptor blockers, as well as combinations thereof. There is disagreement regarding the optimal mono- and combination therapies for treating patients with hypertension, and this DSEN query seeks to address the uncertainty regarding this issue. In this proposal we outline a research proposal involving use of network meta-analysis to compare the benefits of the above approaches to pharmacotherapy of patients with regard to their effects on important clinical outcomes including blood pressure control, adherence to treatment, and complications such as heart attacks, coronary artery disease and death. Findings from this work will be shared with stakeholders to maximize awareness of the information generated.