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REFLECTIONS
Hypertension
Hypertension Global Newsletter #4 2023

Knowledge gaps identified include the nature of the association
CLINICAL PEARLS FROM THE FACULTY of gynaecological disorders and adverse pregnancy outcomes
with hypertension and CVD, sex-specific risk prediction models,
Hypertension
the optimal choice of antihypertensive drugs for women, and the
thresholds for hypertension management, which should take
the lower BP level at which HMOD and CVD occur in women
into account. The authors also note that “women should be
empowered to govern their own cardiovascular health and made
aware of the close link with reproductive health.”

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Five-year outcomes of the Danish cardiovascular screening (DANCAVAS) trial.
Lindholt JS, et al. N Engl J Med. 2022 Oct 13;387(15):1385-1394.

The Danish Cardiovascular Screening (DANCAVAS) Trial is a
population-based, parallel-group, randomized trial that evaluated
the efficacy of population-based screening for cardiovascular
disease. Men aged 65 to 74 years living in Denmark (n=46,611)
were randomly assigned to be invited to undergo cardiovascular
screening or not to be invited (control group). Screening
consisted of 1) non-contrast ECG-gated CT to determine the
coronary-artery calcium score and to detect aneurysms and
atrial fibrillation; 2) ankle-brachial BP measurement to detect
peripheral artery disease and hypertension; and 3) a blood
sample to detect diabetes mellitus and hypercholesterolemia.
The primary outcome was death from any cause.

At a median follow-up of 5.6 years, the incidence of death from
any cause did not differ significantly between the control group
(13.1%) and the invited group (12.6%). The hazard ratio for
stroke in the invited group, as compared with the control group,
was 0.93 (95% CI, 0.86 to 0.99); for myocardial infarction, 0.91
(95% CI, 0.81 to 1.03); for aortic dissection, 0.95 (95% CI, 0.61
to 1.49); and for aortic rupture, 0.81 (95% CI, 0.49 to 1.35).
There were also no significant differences between the two
groups regarding safety outcomes, including incident cancer
(20.3%, control group; 19.8%, invited group).

The initiation of antiplatelet and lipid-lowering agents was more
common in the invited group than in the control group, while
prescription anticoagulant, antihypertensive, and antidiabetic
agents were similar in the two groups. The adherence to

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