Gå direkt till huvudinnehållet

Hypertoni

Senast uppdaterad: Senast reviderad:
Sakkunnig:


Definition:
Hypertoni utgör en riskfaktor för hjärt-kärlsjukdom och delas in i mild, måttlig och svår hypertoni. 
Förekomst:
I Sverige beräknas ungefär 25–30 % av den vuxna befolkningen ha hypertoni.
Symtom:
Hypertoni ger i regel inga symtom, förutom vid mycket högt blodtryck.
Kliniska fynd:
Diagnosen ställs efter upprepade blodtrycksmätningar under standardiserade förhållanden.
Diagnostik:
Gränsen för hypertoni är ett medelvärde >140/90 mmHg vid upprepade mätningar. Förutom mätningar på vårdenheter kan hemblodtryckmätningar och ambulatorisk blodtrycksmätning ingå. 
Behandling:
Livsstilsåtgärder och eventuellt läkemedel rekommenderas, beroende på graden av hypertoni. Vid måttlig–svår hypertoni bör behandlingen påbörjas snarast, ofta i form av kombinationsbehandling från två läkemedelsgrupper.
  1. Messerli FH, Williams B, Ritz E. Essential hypertension. Lancet 2007; 370: 591-603. PubMed  
  2. Verdecchia P, Staessen JA, White WB, Imai Y, O'Brien ET. Properly defining white coat hypertension. Eur Heart J 2002; 23: 106-09. pmid:11785991 PubMed  
  3. Mancia G, Facchetti R, Bombelli M, Grassi G and Sega R. Long-term risk of mortality associated with selective and combined elevation in office, home, and ambulatory blood pressure. Hypertension 2006; 47: 846-53. PubMed  
  4. Gustavsen P, Hansen TW. Prognostisk betydning af »white coat« og maskeret hypertension. Ugeskriftet Laeger 2009; 171: 2019-2022. ugeskriftet.dk  
  5. Staplin N, de la Sierra A, Ruilope LM, et al. Relationship between clinic and ambulatory blood pressure and mortality: an observational cohort study in 59 124 patients. Lancet. 2023;401(10393):2041-2050. PMID:37156250. PubMed  
  6. Holmen J (red), Aursnes I, Forsdahl A, Hetlevik I, Hjerman I, Hjort PF og medarbeidere. Høyt blodtrykk. NSAMs handlingsprogram. Verdal: Samfunnsmedisinsk forskningssenter (Folkehelsa), Utredningsrapport nr. U3, 1993
  7. Läkemedelsverket. Att förebygga aterosklerotisk hjärt-kärlsjukdom med läkemedel - behandlingsrekommendation. 5:2014. (Hämtad 2016-07-28) lakemedelsverket.se  
  8. Cutler JA, Sorlie PD, Worlz M et al. Trends in hypertension prevalence, awareness, treatment and control rates in United States adults between 1988-1994 and 1999-2004. Hypertension 2008; 52: 818-27. PubMed  
  9. Käyser SC, Deinum J, de Grauw WJ, et al. Prevalence of primary hyperaldosteronism in primary care: a cross-sectional study. Br J Gen Pract 2018; 68(667): e114-122. pmid:29335324 PubMed  
  10. McEvoy JW, Daya N, Rahman F, et al. Association of Isolated Diastolic Hypertension as Defined by the 2017 ACC/AHA Blood Pressure Guideline With Incident Cardiovascular Outcomes. JAMA 2020; 323: 329-38. pmid:31990314 PubMed  
  11. Luft FC. Twins in cardiovascular genetic research. Hypertension 2001; 37(2 Pt 2): 350-6. pmid:11230299 PubMed  
  12. Ellervik C, Tarnow L, Pedersen EB. Genetik og hypertension. Ugeskr Læger 2009; 171: 2012. Ugeskrift for Læger  
  13. Institute of Medicine Committee on Public Health Priorities to reduce and control hypertension. A Population-Based Policy and Systems Change Approach to Prevent and Control Hypertension. Washington (DC): National Academies Press (US); 2010.
  14. Holmlund T, Ekblom Bak E. Långsiktigt försämrad kondition ger ökad risk för hypertoni. Lakartidningen.se 2020-10-20. lakartidningen.se  
  15. SBU aug. 2015. En systematisk litteraturöversikt om arbetsmiljöns betydelse för hjärt-kärlsjukdom www.sbu.se  
  16. Arbetsmiljöns betydelse för hjärt-kärlsjukdom – exponering för kemiska ämnen. SBU utvärderar. Rapport 261/2017. www.sbu.se  
  17. Guimont C, Brisson C, Dagenais GR, et al. Effects of job strain on blood pressure: a prospective study of male and female white-collar workers. Am J Public Health 2006; 96: 1436-43. PubMed  
  18. Hagen K, Stovner LJ, Vatten L et al. Blood pressure and risk of headache: a prospective study of 22 685 adults in Norway. J Neurol Neurosurg Psychiatry 2002; 72(4): 463. pmid:11909904 PubMed  
  19. O'Brien E1, Parati G, Stergiou G, et al. European Society of Hypertension position paper on ambulatory blood pressure monitoring. J Hypertens. 2013; 31(9):1731-68. PMID: 24029863 PubMed  
  20. Sandvik E, Stein S, Kjeldsen S. Hjemmemåling av blodtrykk hos pasienter i allmennpraksis. Tidsskr Nor Lægeforen 1996; 116: 2566-9 PubMed  
  21. Mancia G, De Backer G, Dominiczak A, et al. 2007 guidelines for the management of arterial hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 2007; 25: 1105-87. pmid:17563527 PubMed  
  22. Pewsner D, Jüni P, Egger M, et al. Accuracy of electrocardiography in diagnosis of left ventricular hypertrophy in arterial hypertension: systematic rev. BMJ 2007; 335(7622):711. www.bmj.com  
  23. Cappuccio FP, Kerry SM, Forbes L, Donald A. Blood pressure control by home monitoring: meta-analysis of randomised trials. BMJ 2004; 329: 145-8. PubMed  
  24. Dellborg M, Furenäs E, Söderberg B, Eriksson P. Coarctatio aortae--viktig differentialdiagnos vid hypertoni hos unga Aortic coarctation--important differential diagnosis in hypertension in young people. Lakartidningen. 2010;107(12):827-830. PMID:20432830. PubMed  
  25. Baumgartner H, De Backer J, Babu-Narayan SV, et al. 2020 ESC Guidelines for the management of adult congenital heart disease. Eur Heart J. 2021;42(6):563-645. PMID:32860028. PubMed  
  26. Ishigami J, Charleston J, Miller ER 3rd et al. Effects of Cuff Size on the Accuracy of Blood Pressure Readings: The Cuff(SZ) Randomized Crossover Trial. JAMA Intern Med. 2023 Aug 7:e233264. Epub ahead of print. PMID: 37548984 PubMed  
  27. Kahan T, Boström K. Hypertoni. Information från läkemedelsverket (2015). Bakgrundsdokumentation. (Hämtad 2016-09-20) lakemedelsverket.se  
  28. Grassi G, Quarti-Trevani F, Seravalle G, et al. Sympathetic Neural Mechanisms Underlying Attended and Unattended Blood Pressure Measurement. Hypertension 2021; 78: 1126-33. pmid:34365811 PubMed  
  29. Hypertension in adults: diagnosis and management. NICE, 2011. (Hämtad 2016-09-21) www.nice.org.uk  
  30. Tholl U, Forstner K and Anlauf M. Measuring blood pressure: pitfalls and recommendations. Nephrol Dial Transplant 2004; 19: 766-70. PubMed  
  31. Rogers P, Burke V, Stroud P and Puddey IB. Comparison of oscillometric blood pressure measurements at the wrist with an upper-arm auscultatory mercury sphygmomanometer. Clin Exp Pharmacol Physiol 1999; 26: 477-81. PubMed  
  32. Zweiker R, Schumacher M, Fruhwald FM, Watzinger N and Klein W. Comparison of wrist blood pressure measurement with conventional sphygmomanometry at a cardiology outpatient clinic. J Hypertens 2000; 18: 1013-8. PubMed  
  33. Mancia G, Zanchetti A, Agabiti-Rosei E, et al. Ambulatory blood pressure is superior to clinic blood pressure in predicting treatment-induced regression of left ventricular hypertrophy. Circulation 1997; 95: 1464-70. pmid:9118514 PubMed  
  34. Myers MG. Replacing manual sphygmomanometers with automated blood pressure measurement in routine clinical practice. Clin Exp Pharmacol Physiol. 2014 Jan;41(1):46-53. doi: 10.1111/1440-1681.12149. DOI  
  35. Cloutier L, Daskalopoulou SS, Padwal RS, et al. A New Algorithm for the Diagnosis of Hypertension in Canada. Can J Cardiol. 2015 May; 31(5):620-30. PubMed  
  36. Gerdts E, Omvik P, Mo R, Kjeldsen SE . Hypertensjon og hjertesykdom. Tidsskr Nor Lægeforen 2004; 124: 802-5. Tidsskrift for Den norske legeforening  
  37. Conen D, et al. Usefulness of B-type natriuretic Peptide and C-reactive protein in predicting the presence or absence of left ventricular hypertrophy in patients with systemic hypertension. Am J Cardiol. 2006; 97: 249-52. PubMed  
  38. van den Born B-JH, Hulsman CAA, Hoekstra JBL, Schlingemann RO, van Montfrans GA. Value of routine fundoscopy in patients with hypertension: systematic review. BMJ 2005; 331: 73. doi:16002881
  39. Fowkes FG, Murray GD, Butcher I, et al.. Ankle brachial index combined with Framingham Risk Score to predict cardiovascular events and mortality: a meta-analysis.. JAMA 2008; 300: 197-208. doi:10.1001/jama.300.2.197 DOI  
  40. Ragnarsson O, Muth A, Johannsson G, et al. Primär aldosteronism är en under­diagnostiserad orsak till hypertoni. Läkartidningen. 2015;112:DRFR. www.lakartidningen.se  
  41. Funder JW, Carey RM, Mantero F, et al. The Management of Primary Aldosteronism: Case Detection, Diagnosis, and Treatment: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 2016; 101(5): 1889-916. pmid:26934393 PubMed  
  42. Qaseem A, Wilt TJ, Rich R, et al. Pharmacologic Treatment of Hypertension in Adults Aged 60 Years or Older to Higher Versus Lower Blood Pressure Targets: A Clinical Practice Guideline From the American College of Physicians and the American Academy of Family Physicians. Ann Intern Med 2017; 166(6): 430-37. pmid:28135725 PubMed  
  43. Williams B, Mancia G, Spiering W, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J 2018;39:3021-3104. doi:10.1093/eurheartj/ehy339 DOI  
  44. DEGAM. Leitlinien der DEGAM. Inget datum (Hämtad 2022-10-06). www.degam.de  
  45. NHS England. Hypertension in adults: diagnosis and treatment. Aug 2019 (Hämtad 2022-10-06). www.nice.org.uk  
  46. Nagele E, Jeitler K, Horvath K, et al. Clinical effectiveness of stress-reduction techniques in patients with hypertension: systematic review and meta-analysis. J Hypertens. 2014; 32(10):1936-44. pmid:25084308 PubMed  
  47. Appel LJ, Champagne CM, Harsha DW, et al. Effects of comprehensive lifestyle modification on blood pressure control: main results of the PREMIER clinical trial. JAMA 2003; 289: 2083-93. doi:10.1001/jama.289.16.2083 DOI  
  48. Råd om salt. Livsmedelsverket (2014). www.slv.se  
  49. Mente A, O'Donnell M, Rangarajan S, et al. Urinary sodium excretion, blood pressure, cardiovascular disease, and mortality: a community-level prospective epidemiological cohort study. Lancet 2018; 392(10146): 496-506. pmid:30129465 PubMed  
  50. Ard JD, Svetkey LP, La Chance P-A, Bray G. Lowering blood pressure using a dietary pattern: A review of the dietary approaches to stop hypertension (DASH) trial. J Clin Hypertens 2000; 2: 387-91. PubMed  
  51. Binia A, Jaeger J, Hu Y, et al. Daily potassium intake and sodium-to-potassium ratio in the reduction of blood pressure: a meta-analysis of randomized controlled trials. J Hypertens. 2015; 33(8):1509-20. PubMed  
  52. Beveridge LA, Struthers AD, Khan F, et al. Effect of Vitamin D Supplementation on Blood Pressure: A Systematic Review and Meta-analysis Incorporating Individual Patient Data. JAMA Intern Med. 2015;175(5):745-54. pmid:25775274 PubMed  
  53. UpToDate. (2016) Cardiovascular benefits and risks of moderate alcohol consumption. (Hämtad 2016-10-27) www.uptodate.com  
  54. WHO (2013). WHO issues new guidance on dietary salt and potassium. (Hämtad 2016-10-13). www.who.int  
  55. He FJ, Li J, Macgregor GA. Effect of longer-term modest salt reduction on blood pressure. Cochrane Database Syst Rev 2013; 4: CD0044937. pmid:23633321 PubMed  
  56. He FJ, Li J, Macgregor GA. Effect of longer-term modest salt reduction on blood pressure. Cochrane Database Syst Rev. 2013 Apr 30;4. PMID: 15266549. PubMed  
  57. Suckling RJ, He FJ, Markandu ND, MacGregor GA. Modest Salt Reduction Lowers Blood Pressure and Albumin Excretion in Impaired Glucose Tolerance and Type 2 Diabetes Mellitus: A Randomized Double-Blind Trial. Hypertension 2016; 67(6): 1189-95. pmid:27160199 PubMed  
  58. Johnson C, Raj TS, Trudeau L et al. The science of salt: a systematic review of clinical salt studies 2013 to 2014. J Clin Hypertens (Greenwich). 2015;17(5):401-11. PubMed  
  59. Yin X, Rodgers A, Perkovic A, et al. Effects of salt substitutes on clinical outcomes: a systematic review and meta-analysis. Heart. 2022;108(20):1608-1615. Published 2022 Sep 26. PMID:35945000. PubMed  
  60. He FJ, MacGregor GA. Importance of salt in determining blood pressure in children. Metaanalysis of controlled trials. Hypertension 2006; 48: 861-9. PubMed  
  61. Mozaffarian D, Fahimi S, Singh GM, et al. Global Sodium Consumption and Death from Cardiovascular Causes. N Engl J Med 2014; 371: 624-34. doi:10.1056/NEJMoa1304127. DOI  
  62. Kalogeropoulos AP, Georgiopoulou VV, Murphy RA. Dietary Sodium Content, Mortality, and Risk for Cardiovascular Events in Older Adults The Health, Aging, and Body Composition (Health ABC) Study. JAMA Intern Med. 2015; 175(3):410-9. doi:10.1001/jamainternmed.2014.6278. DOI  
  63. O’Donnell M, Mente A, Rangarajan S, et al. Urinary Sodium and Potassium Excretion, Mortality, and Cardiovascular Events. N Engl J Med 2014;371: 612–623. DOI: 10.1056/NEJMoa1311889.
  64. Mente A, O'Donnell MJ, Rangarajan S, et al. Association of Urinary Sodium and Potassium Excretion with Blood Pressure. N Eng J Med 2014; 371: 601–611. DOI: 10.1056/NEJMoa1311989.
  65. Filippini T, Malavolti M, Whelton PK, et al. Blood Pressure Effects of Sodium Reduction Dose–Response Meta-Analysis of Experimental Studies. Circulation 2021; 146: 1542-67. pmid:33586450 PubMed  
  66. Whelton SP, Chin A, Xin X, He J. Review: aerobic exercise reduces systolic and diastolic blood pressure in adults. Ann Intern Med 2002; 136: 493-503. PubMed  
  67. Carlson DJ, Dieberg G, Hess NC, et al. Isometric exercise training for blood pressure management: a systematic review and meta-analysis. Mayo Clin Proc. 2014 Mar;89(3):327-34. doi: 10.1016/j.mayocp.2013.10.030. DOI  
  68. FYSS (2015). Fysisk aktivitet vid hypertoni. (Hämtad 2016-10-13) fyss.se  
  69. Semlitsch T, Jeitler K, Hemkens LG, et al. Increasing physical activity for the treatment of hypertension: a systematic review and meta-analysis. Sports Med. 2013 Oct;43(10):1009-23. doi: 10.1007/s40279-013-0065-6.
  70. Börjesson M, Onerup A, Lundqvist S et al. Physical activity and exercise lower blood pressure in individuals with hypertension: narrative review of 27 RCTs.Br J Sports Med. 2016 Mar;50(6):356-61. PMID:26787705 PubMed  
  71. Inder JD, Carlson DJ, Dieberg G et al. Isometric exercise training for blood pressure management: a systematic review and meta-analysis to optimize benefit. Hypertens Res. 2016;39(2):88-94. pmid:26467494. PubMed  
  72. Park S, Han K, Lee S, et al. Cardiovascular or mortality risk of controlled hypertension and importance of physical activity. Heart 2021. pmid:33402363 PubMed  
  73. Brand MB, Mulrow CD, Chiquette E, Angel L, Cornell J, Summerbell C, Anagnostelis B, Grimm R. Weight-reduction through dieting for control of hypertension in adults. Oxford: The Cochrane Library, 1999, issue 1. Last amendment: 20 July 1998 The Cochrane Library  
  74. Aucott L, Poobalan A, Smith WC, Avenell A, Jung R and Broom J. Effects of weight loss in overweight/obese individuals and long-term hypertension outcomes: a systematic review. Hypertension 2005; 45: 1035-41. PubMed  
  75. Adami G, Murelli F, Carlini F, Papadia F and Scopinaro N. Long-term effect of biliopancreatic diversion on blood pressure in hypertensive obese patients. Am J Hypertens 2005; 18: 780-4. PubMed  
  76. Semlitsch T, Jeitler K, Berghold A. Long-term effects of weight-reducing diets in people with hypertension. Cochrane Database Syst Rev 2016; 3: CD008274. pmid:2693451 PubMed  
  77. Socialstyrelsen (2011). Nationella riktlinjer för sjukdomsförebyggande metoder 2011 – stöd för styrning och ledning. (Hämtad 2016-10-13) www.socialstyrelsen.se  
  78. Sheppard JP, Koshiaris C, Stevens R et al. The association between antihypertensive treatment and serious adverse events by age and frailty: A cohort study. PLoS Med. 2023 Apr 19;20(4):e1004223. doi: 10.1371/journal.pmed.1004223. PMID: 37075078 PubMed  
  79. Ljungman C, Treatment of Hypertension in Women and Men, ISBN 978-91-628-8994-4, Printed by Kompendiet, Gothenburg, Sweden 2014. hdl.handle.net  
  80. Law MR, Wald NJ, Morris JK, Jordan RE. Value of low dose combination treatment with blood pressure lowering drugs: analysis of 354 randomised trials. BMJ 2003; 326: 1427-34. PubMed  
  81. Mancia G, Laurent S, Agabiti-Rosei E, et al. Reappraisal of European guidelines on hypertension management: a European Society of Hypertension Task Force document. J Hypertens 2009; 27(11):2121-58. PMID:19838131. PubMed  
  82. O'Hagan ET, McIntyre D, Nguyen T, Chow CK. Hypertension therapy using fixed-dose polypills that contain at least three medications. Heart 2023. pmid:36810213 PubMed  
  83. Boffa RJ, Constanti M, Floyd CN, et al. Hypertension in adults: summary of updated NICE guidance. BMJ 2019; 367: l5310. pmid:31636059 PubMed  
  84. Garjon J, Saiz LC, Azparren A, et al. First-line combination therapy versus first-line monotherapy for primary hypertension. Cochrane Database Syst Rev. 2020 Feb 6;2:CD010316. doi: 10.1002/14651858.CD010316.pub3 DOI  
  85. Combination therapy in hypertension: what are the best options according to clinical pharmacology principles and controlled clinical trial evidence? Am J Cardiovasc Drugs. 2015 Jun; 15(3):185-94. PubMed  
  86. Dahlöf B, Sever PS, Poulter NR et al. Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required, in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA): a multicentre randomised controlled trial. Lancet 2005; 366: 895-906. PubMed  
  87. Williams B, MacDonald TM, Morant S, et al. Spironolactone versus placebo, bisoprolol, and doxazosin to determine the optimal treatment for drug-resistant hypertension (PATHWAY-2): a randomised, double-blind, crossover trial. Lancet. 2015; 386:2059-2068. PMID: 26414968. PubMed  
  88. Chen RC, Suchard MA, Krumholz HM, et al. Comparative First-Line Effectiveness and Safety of ACE (Angiotensin-Converting Enzyme) Inhibitors and Angiotensin Receptor Blockers: A Multinational Cohort Study. Hypertension 2021. pmid:34304580 PubMed  
  89. Ringerike T, Reikvam Å , Gjertsen MK. Effekt og sikkerhet av angiotensin reseptorblokkere med og uten diuretika hos pasienter med hypertensjon, hjertesvikt eller diabetisk nefropati. Rapport fra Kunnskapssenteret nr 24 - 2008.
  90. Li EC, Heran BS, Wright JM.Angiotensin converting enzyme (ACE) inhibitors versus angiotensin receptor blockers for primary hypertension. Cochrane Database Syst Rev. 2014 Aug 22;8:CD009096. doi: 10.1002/14651858.CD009096.pub2. The Cochrane Library  
  91. Elgendy IY, Huo T, Chik V et al. Efficacy and safety of angiotensin receptor blockers in older patients: a meta-analysis of randomized trials. Am J Hypertens. 2015; 28(5):576-85 PubMed  
  92. Tocci G, Battistoni A, Passerini J, et al. Calcium channel blockers and hypertension. J Cardiovasc Pharmacol Ther. 2015 Mar;20(2):121-30. pmid:25398848 PubMed  
  93. Musini VM, Rezapour P, Wright JM, et al. Blood pressure-lowering efficacy of loop diuretics for primary hypertension. Cochrane Database Syst Rev. 2015 May 22;5:CD003825. Cochrane (DOI)  
  94. Wiysonge CS, Bradley H, Mayosi BM, et al. Beta-blockers for hypertension. Cochrane Database Syst Rev. 2007. pmid:7253471 PubMed  
  95. National Collaborating Centre for Chronic Conditions. Hypertension: management of hypertension in adults in primary care: partial update. London: Royal College of Physicians, 2006.
  96. Lindholm LH, Carlberg B, Samuelsson O. Should beta-blockers remain first choice in the treatment of primary hypertension? A meta-analysis. Lancet 2005; 366: 1545-53. PubMed  
  97. Mayor S. NICE removes beta blockers as first line treatment for hypertension (www.nice.org.uk). BMJ 2006; 333: 8. PubMed  
  98. Läkemedelsverket. Läkemedelsboken. Stockholm: Läkemedelsverket, 2014. xn--lkemedelsboken-5hb.se  
  99. Wong GW, Wright JM. Blood pressure lowering efficacy of nonselective beta-blockers for primary hypertension. Cochrane Database Syst Rev. 2014 Feb 28;2:CD007452. PMID: 24585007. PubMed  
  100. Choi HK, Soriano LC, Zhang Y, Rodriguez LAG. Antihypertensive drugs and risk of incident gout among patients with hypertension: population based case-control study. BMJ 2012; 344: d8190. BMJ (DOI)  
  101. Hypertensjonsbehandling i første trimester, RELIS database 2010; spm.nr. 2188, RELIS Nord-Norge relis.arnett.no  
  102. Bramham K, Parnell B, Nelson-Piercy C, et al. Chronic hypertension and pregnancy outcomes: systematic review and meta-analysis. BMJ. 2014; 348:g2301. doi: 10.1136/bmj.g2301. DOI  
  103. Ibsen H, Jørgensen T, Jensen GB, Jacobsen IA. Hypertension - forekomst og behandling. Ugeskr Læger 2009; 171: 1998. Ugeskrift for Læger  
  104. The Blood Pressure Lowering Treatment Trialists’ Collaboration. Blood pressure-lowering treatment based on cardiovascular risk: a meta-analysis of individual patient data. Lancet 2014; 384: 591–98. doi:10.1016/S0140-6736(14)61212-5. DOI  
  105. Ettehad D, Emdin CA, Kiran A, et al. Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis. Lancet 2016; 387: 957-967. pmid:26724178 PubMed  
  106. Musini VM, Tejani AM, Bassett K, et al. Pharmacotherapy for hypertension in adults 60 years or older. Cochrane Database of Systematic Reviews 2019, Issue 6. Art. No.: CD000028. DOI: 10.1002/14651858.CD000028.pub3. DOI  
  107. Janusinfo (2017-11-23). Nya amerikanska hypertoniriktlinjer skärper kraven. (Hämtad 2017-12-05) www.janusinfo.se  
  108. Brunström M, Carlberg B. Association of Blood Pressure Lowering With Mortality and Cardiovascular Disease Across Blood Pressure Levels: A Systematic Review and Meta-analysis. JAMA Intern Med 2017; Nov 13. Published online. pmid:29131895 PubMed  
  109. Arguedas JA, Leiva V, Wright JM.Blood pressure targets for hypertension in people with diabetes mellitus. Cochrane Database Syst Rev. 2013 Oct 30;10:CD008277. doi: 10.1002/14651858.CD008277.pub2. DOI  
  110. Xie X, Atkins E, Lv J et al. Effects of intensive blood pressure lowering on cardiovascular and renal outcomes: updated systematic review and meta-analysis. Lancet. 2016; 387:435-43. PubMed  
  111. The SPRINT Research Group. A Randomized Trial of Intensive versus Standard Blood-Pressure Control. N Engl J Med 2015; 373: 2103-2116. pmid:26551272 PubMed  
  112. Arguedas JA, Perez MI, Wright JM. Treatment blood pressure targets for hypertension. Cochrane Database Syst Rev 2009; 3: CD004349. Cochrane (DOI)  
  113. Reboussin DM, Allen NB, Griswold ME, et al. Systematic Review for the 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2018; 71:2176-98. PMID: 29146534 PubMed  
  114. SPRINT Research Group, Lewis CE, Fine LJ, et al. Final Report of a Trial of Intensive versus Standard Blood-Pressure Control. N Engl J Med. 2021;384(20):1921-1930. PMID:34010531. PubMed  
  115. Jaeger BC, Bress AP, Bundy JD, et al. Longer-Term All-Cause and Cardiovascular Mortality With Intensive Blood Pressure Control A Secondary Analysis of a Randomized Clinical Trial. JAMA Cardiol 2022. pmid:36223105 PubMed  
  116. Diao D, Wright JM, Cundiff DK, et al. Pharmacotherapy for mild hypertension. Cochrane Database Syst Rev. 2012 Aug 15;8:CD006742. The Cochrane Library  
  117. Sundström J, Arima H, Jackson R, et al. Effects of blood pressure reduction in mild hypertension: a systematic review and meta-analysis. Ann Intern Med. 2015; 162(3):184-91. PMID:25531552. PubMed  
  118. Wong GW, Laugerotte A, Wright JM Blood pressure lowering efficacy of dual alpha and beta blockers for primary hypertension. Cochrane Database Syst Rev. 2015 Aug 26;8:CD007449. Cochrane (DOI)  
  119. Mancia G, Fagard R, Narkiewicz K, et al; Task Force Members. 2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 2013;31:1281–357.
  120. McManus RJ, Mant J, Bray EP, et al. Telemonitoring and self-management in the control of hypertension (TASMINH2): a randomised controlled trial. Lancet 2010; 376: 163-72. PubMed  
  121. Ahmed M, Nudy M, Bussa R, et al. A Subgroup Meta-Analysis Comparing the Renal Denervation Sham-Controlled Randomized Trials Among Those With Resistant and Nonresistant Hypertension. Am J Cardiol. 2023;191:119-124. PMID: 36669381 PubMed  
  122. Olsen LK, Kamper AL, Svendsen JH, et al. Renal denervation. Eur J Intern Med. 2015; 26(2):95-105. pmid:25676808 PubMed  
  123. Howard JP, Nowbar AN, Francis DP. Size of blood pressure reduction from renal denervation: insights from meta-analysis of antihypertensive drug trials of 4121 patients with focus on trial design: the CONVERGE report. Heart 2013; 99(21):1579-87. doi:10.1136/heartjnl-2013-304238 DOI  
  124. Davis MI, Filion KB, Zhang D, et al. Effectiveness of renal denervation therapy for resistant hypertension: a systematic review and meta-analysis. J Am Coll Cardiol 2013; 62(3):231-41. doi: 10.1016/j.jacc.2013.04.010.
  125. Krum H, Schlaich MP, Sobotka PA, et al. Percutaneous renal denervation in patients with treatment-resistant hypertension: final 3-year report of the Symplicity HTN-1 study. Lancet 2014; 383: 622-9. doi:10.1016/S0140-6736(13)62192-3 DOI  
  126. Bhatt DL, Kandzari DE, O'Neill WW, et al for the SYMPLICITY HTN-3 Investigators. A controlled trial of renal denervation for resistant hypertension. N Engl J Med 2014; 370(15):1393-401. doi:10.1056/NEJMoa1402670 DOI  
  127. Gupta A, Prince M, Bob-Manuel T, et al. Renal denervation: Alternative treatment options for hypertension? Prog Cardiovasc Dis. 2020; 63(1):51-57. www.ncbi.nlm.nih.gov  
  128. Reddi AS. Resistant hypertension: is renal denervation the current treatment of choice? Clin Exp Hypertens. 2014;36(8):525-30. doi: 10.3109/10641963.2014.881846. DOI  
  129. Iliescu R, Lohmeier TE, Tudorancea I, et al. Renal denervation for the treatment of resistant hypertension: review and clinical perspective. Am J Physiol Renal Physiol. 2015; 309(7):F583-94. pmid:26224718 PubMed  
  130. Christensen H, Strandgaard S. Hypertension og hjernen. Ugeskr Læger 2009; 171: 2025. Ugeskrift for Læger  
  131. Franklin SS, Larson MG, Khan SA, et al. Does the relation of blood pressure to coronary heart disease change with aging? The Framingham Heart Study. Circulation 2001; 103: 1245-49. Circulation  
  132. Birtwhistle RV, Godwin MS, Delva MD, et al. Randomised equivalence trial comparing three and six months of follow-up of patients with hypertension by family practitioners. BMJ 2004; 328:204-6. British Medical Journal  
  133. O’Brien E, Asmar R, Beilin L, Imai Y, Mancia G, Mengden T, et al. Practice guidelines of the European Society of Hypertension for clinic, ambulatory and self blood pressure measurement. J Hypertens 2005; 23: 697-701. PubMed  
  134. Fahey T, Schroeder K, Ebrahim S. Interventions used to improve control of blood pressure in patients with hypertension. Cochrane Database Syst Rev 2003; CD005182. Cochrane (DOI)  
  135. McManus RJ, Mant J, Roalfe A, Oakes RA, Bryan S, Pattison HM, et al. Targets and self monitoring in hypertension: randomised controlled trial and cost effectiveness analysis. BMJ 2005; 331: 493-6. British Medical Journal  
  136. Green BB, Cook AJ, Ralston JD. Effectiveness of Home Blood Pressure Monitoring, Web Communication, and Pharmacist Care on Hypertension Control: A Randomized Controlled Trial. JAMA 2008; 299: 2857-67. PubMed  
  • Peter M Nilsson, allmänläkare, professor i klinisk kardiovaskulär forskning och forskargruppschef Internmedicin - Epidemiologi; samt överläkare vid Klinisk Forskningsenhet, VO Internmedicin, SUS, Malmö