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Current Hypertension Reports

Jordana B Cohen, Kishore M Gadde
PURPOSE OF REVIEW: Weight loss is strongly associated with improvement in blood pressure; however, the mechanism of weight loss can impact the magnitude and sustainability of blood pressure reduction. RECENT FINDINGS: Five drugs-orlistat, lorcaserin, liraglutide, phentermine/topiramate, and naltrexone/bupropion-are currently approved for weight loss therapy in the USA. Naltrexone/bupropion results in an increase in in-office and ambulatory blood pressure compared to placebo...
February 12, 2019: Current Hypertension Reports
Nadia Liyanage-Don, Deborah Fung, Erica Phillips, Ian M Kronish
PURPOSE OF REVIEW: To review data supporting the use of home blood pressure monitoring (HBPM) and provide practical guidance to clinicians wishing to incorporate HBPM into their practice. RECENT FINDINGS: HBPM more accurately reflects the risk of cardiovascular events than office blood pressure measurement. In addition, there is high-quality evidence that HBPM combined with clinical support improves blood pressure control. Therefore, HBPM is increasingly recommended by guidelines to confirm the diagnosis of hypertension and evaluate the efficacy of blood pressure-lowering medications...
February 12, 2019: Current Hypertension Reports
Paul J Nestel
PURPOSE OF REVIEW: Do dietary fats lower blood pressure? This review covers total fats, individual fatty acids and foods that provide specific fats. RECENT FINDINGS: Evidence for blood pressure lowering is stronger for supplements providing individual marine fatty acids than for fish intake since data on fish consumption are scarce. Such effects are more readily apparent in hypertensive than normal subjects. Biological mechanisms to support linkage between dietary fish oils and blood pressure are plausible...
February 12, 2019: Current Hypertension Reports
Sarah Melville, James Brian Byrd
PURPOSE OF REVIEW: The purpose of this review is to discuss the implications of personalized medicine for the treatment of hypertension, including resistant hypertension. RECENT FINDINGS: We suggest a framework for the personalized treatment of hypertension based on the concept of a trade-off between simplicity and personalization. This framework is based on treatment strategies classified as low, medium, or high information burden personalization approaches. The extent to which a higher information burden is justified depends on the clinical scenario, particularly the ease with which the blood pressure can be controlled...
February 12, 2019: Current Hypertension Reports
Hillel Sternlicht, George L Bakris
PURPOSE OF REVIEW: This is an update of data regarding changes in blood pressure using sodium-glucose co-transporter 2 inhibitors (SGLT2i) for the treatment of diabetes. The mechanism of blood pressure lowering by SGLT2i was thought to be due to their osmotic diuretic effects. New data, however, has emerged from meta-analyses and studies of people with impaired kidney function demonstrating similar or greater magnitudes of blood pressure reduction in the absence of significant glycosuria...
February 12, 2019: Current Hypertension Reports
Edem Binka, Tammy M Brady
PURPOSE OF REVIEW: To review the most recent literature on current strategies for the treatment of hypertension associated with pediatric obesity. RECENT FINDINGS: Over the last three decades, childhood and adolescent overweight and obesity prevalence in the USA has continued to rise. Unsurprisingly but rather disturbingly, this rising prevalence has been paralleled by an increase in cardiovascular disease (CVD) risk factors in childhood such as hypertension, dyslipidemia, and diabetes that become manifest earlier than previously reported...
February 12, 2019: Current Hypertension Reports
Songtao Liu, Ping Li, Hai Su
PURPOSE OF REVIEW: Traditionally, the term peripheral vascular disease (PAD) is restricted to the occlusive arterial disease in the leg, but now, the connotation of PAD is more widespread as it encompasses all extracoronary and extracerebral vascular disease. The incidence of PAD is increasing worldwide; therefore, it is necessary to diagnose PAD at an early stage. RECENT FINDINGS: Oscillometric BP device is widely used for four-limb measurement in clinical practice and provides several parameters for evaluating inter-limb BP difference, such as ankle-brachial index (OS-ABI), inter-arm BP differences (IAD), and inter-ankle BP difference (IAND)...
February 12, 2019: Current Hypertension Reports
Scott J Dankel, Minsoo Kang, Takashi Abe, Jeremy P Loenneke
PURPOSE OF REVIEW: The purpose of this meta-analysis was to compare the magnitude of systematic bias (mean difference) and random error (standard deviation of mean difference) between the cuff method of indirect blood pressure and directly measured intra-arterial pressure. RECENT FINDINGS: Blood pressure is almost exclusively assessed using the indirect cuff method; however, numerous individual studies have questioned the validity relative to directly measured intra-arterial blood pressure...
February 7, 2019: Current Hypertension Reports
Victoria L Wolf, Michael J Ryan
PURPOSE OF REVIEW: To highlight important new findings on the topic of autoimmune disease-associated hypertension. RECENT FINDINGS: Autoimmune diseases including systemic lupus erythematosus and rheumatoid arthritis are associated with an increased risk for hypertension and cardiovascular disease. A complex interaction among genetic, environmental, hormonal, and metabolic factors contribute to autoimmune disease susceptibility while promoting chronic inflammation that can lead to alterations in blood pressure...
February 2, 2019: Current Hypertension Reports
Mark Nelson
PURPOSE OF REVIEW: To address the tension between guideline recommendations and the evidence from clinical trials supporting them and clinician concerns of overtreatment of elevated blood pressure. RECENT FINDINGS: Systolic Blood Pressure Intervention trial (SPRINT) demonstrated lower blood pressure targets provided robust clinical benefit (reduced all-cause mortality) but also expected adverse events due to hypotension. Treatment thresholds for systolic blood pressure in the latest US guidelines have been lowered to 130 mmHg, although this has not been adopted elsewhere...
January 18, 2019: Current Hypertension Reports
Sergio H R Ramalho, Amil M Shah
PURPOSE OF REVIEW: Evaluate the relevant new findings regarding hypertension treatment and heart failure prevention published in the past 3 years. RECENT FINDINGS: In a recent secondary analysis of Systolic Blood Pressure Intervention Trial (SPRINT), randomization of more than 9000 patients > 50 years old with high cardiovascular risk but without diabetes to intensive treatment targeting blood pressure < 120/80 mmHg compared to standard treatment targeting < 140/90 mmHg significantly reduced incident heart failure...
January 18, 2019: Current Hypertension Reports
Michelle A Fravel, Elizabeth Bald, Mony Fraer
PURPOSE OF REVIEW: Hypertension and antihypertensive drug utilization are remarkably prevalent in ESRD patients. Management of blood pressure elevation in this population is complicated by many factors, including a multidimensional etiology, challenges in obtaining accurate and appropriately timed blood pressure measurements, highly specific drug dosing requirements, and a paucity of outcomes-based evidence to guide management decisions. The purpose of this review is to summarize and apply knowledge from existing clinical trials to enhance safe and effective use of antihypertensive agents in dialysis patients...
January 18, 2019: Current Hypertension Reports
Akinori Higaki, Antoine Caillon, Pierre Paradis, Ernesto L Schiffrin
PURPOSE OF REVIEW: To describe the important role played by innate and innate-like immunity in the pathophysiology of hypertension and vascular injury. RECENT FINDINGS: Innate immune cells, such as neutrophils, dendritic cells, myeloid-derived suppressor cells, and monocytes/macrophages and innate lymphoid cells such as natural killer cells and unconventional T lymphocytes like γδ T cells contribute to hypertensive mechanisms by priming adaptive immune cells, leading to the triggering of vascular inflammation and blood pressure elevation or alternatively protecting against vascular injury...
January 18, 2019: Current Hypertension Reports
Bharathi Upadhya, Richard B Stacey, Dalane W Kitzman
PURPOSE OF REVIEW: Previous trials definitively established that lowering systolic blood pressure (BP) to 140 mmHg prevented heart failure (HF) exacerbations, but the potential benefits and risks of further BP reduction remain unclear due to a paucity of trial-based data. RECENT FINDINGS: A recent secondary analysis of the Systolic Blood Pressure Intervention Trial (SPRINT) found that in older, high-risk, non-diabetic participants with systolic hypertension, a BP treatment target < 120 mmHg resulted in a 36% lower rate of acute decompensated HF as compared with a BP target < 140 mmHg...
January 18, 2019: Current Hypertension Reports
Cesar A Romero, Oscar A Carretero
PURPOSE OF REVIEW: In this review, we summarized the current knowledge of connecting tubule-glomerular feedback (CTGF), a novel mechanism of renal microcirculation regulation that integrates sodium handling in the connecting tubule (CNT) with kidney hemodynamics. RECENT FINDINGS: Connecting tubule-glomerular feedback is a crosstalk communication between the CNT and the afferent arteriole (Af-Art), initiated by sodium chloride through the epithelial sodium channel (ENaC)...
January 18, 2019: Current Hypertension Reports
Christopher L Schumann, Nicholas R Jaeger, Christopher M Kramer
PURPOSE OF REVIEW: To review recent advances in the imaging of hypertensive heart disease (HHD) with an emphasis on developments in the imaging of diffuse myocardial fibrosis using cardiac magnetic resonance (CMR). RECENT FINDINGS: HHD results from long-standing hypertension and is characterized by the development of left ventricular hypertrophy and diffuse interstitial fibrosis. Diffuse fibrosis traditionally required endomyocardial biopsy to diagnose, but recent developments using T1 mapping in CMR allow for noninvasive assessment...
January 14, 2019: Current Hypertension Reports
Naoki Nakagawa, Naoyuki Hasebe
PURPOSE OF REVIEW: To estimate the impact of the 2017 American College of Cardiology/American Heart Association (ACC/AHA) guidelines for high blood pressure (BP) on the next hypertension guidelines in Asia. RECENT FINDINGS: The 2017 ACC/AHA guidelines for high BP in adults changed the diagnostic threshold and the management goal of BP from 140/90 to 130/80 mmHg. Another characteristic of the new guideline is its focus on a practical approach for the effective management of hypertension by using home and ambulatory BP monitoring; this point is also recommended in the 2014 Japanese Society of Hypertension Guidelines for the Management of Hypertension...
January 10, 2019: Current Hypertension Reports
N P Bowles, S S Thosar, M X Herzig, S A Shea
The meta-analysis referenced in the "Obstructive Sleep Apnea" section should instead refer to a meta-analysis for chronic kidney disease. Additionally, there are two mis-numbered reference citations in the "chronic kidney disease" section (ref. 107 should ref. 104 [Wang C et al. 2014] and ref. 105.
December 4, 2018: Current Hypertension Reports
Louis Kuritzky, Scott Lang
PURPOSE OF REVIEW: Despite substantive evidence documenting the efficacy of the Mediterranean diet to reduce cardiovascular events, underutilization is common. An overview of the data set supporting the role of the Mediterranean diet as confirmed in both observational and interventional trials should stimulate greater clinician interest in the diet. Additionally, the availability of patient-friendly tools that enable prompt and easy adoption of the Mediterranean diet, that are able to be used by clinicians who claim no special expertise in diet knowledge, should simplify the path to successful dietary change...
November 14, 2018: Current Hypertension Reports
Xiaohan Lu, Steven D Crowley
PURPOSE OF REVIEW: Low-grade inflammation drives elevations in blood pressure (BP) and consequent target organ damage in diverse experimental models of hypertension. Here, we discuss recent advances elucidating immune-mediated mechanisms of BP elevation and associated target organ damage. RECENT FINDINGS: Inflammatory mediators produced by immune cells or target organs act on the kidney, vasculature, skin, and nervous system to modulate hypertension. For example, cells of the innate immune system, including monocytes, neutrophils, and dendritic cells (DCs), can all promote BP elevation via actions in the vasculature and kidney...
October 30, 2018: Current Hypertension Reports
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