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Hypertension And Antihypertensives

Jiapeng Lu, Yuan Lu, Hao Yang, Wuhan Bilige, Yetong Li, Wade Schulz, Frederick A Masoudi, Harlan M Krumholz
Background: As cardiovascular risk increases in China, interest in strategies to mitigate it is growing. However, national information about the prevalence and treatment of high cardiovascular disease (CVD) risk is limited. Objective: To assess the prevalence and treatment of high CVD risk as well as variations in risk across population subgroups. Design: National project of CVD screening and management. Setting: 141 county-level regions in all 31 provinces of China...
February 19, 2019: Annals of Internal Medicine
Ben Stoner-Duncan, Stephen C Morris
A 69-year-old woman with a history of untreated hypertension presented with acute-onset monocular vision loss. Initial workup was delayed due to lack of immediate specialty consultation and dilated funduscopic exam. Point-of-care ultrasound in the emergency department identified a small hyperechoic structure within the distal area of the central retinal artery; in conjunction with specialty ophthalmologic evaluation in a tertiary care center, the diagnosis of central retinal artery occlusion was made. The patient was admitted to the neurology service for stroke risk stratification and was discharged in stable condition with re-initiation of her antihypertensive medication regimen...
February 2019: Clinical practice and cases in emergency medicine
Mohammed Awais Hameed, Indranil Dasgupta
Nonadherence is a common reason for treatment failure and treatment resistance. No matter how it is defined, it is a major issue in the management of chronic illnesses. There are numerous methods to assess adherence, each with its own strengths and weaknesses; however, no single method is considered the best. Nonadherence is common in patients with hypertension, and it is present in a large proportion of patients with uncontrolled blood pressure taking three or more antihypertensive agents. Availability of procedure-based treatment options for these patients has shed further light on this important issue with development of new methods to assess adherence...
2019: Drugs in Context
Rob Cook, Tara Lamont, Rosie Martin
The studySheppard JP, Stevens S, Stevens R, Martin U, Mant J, Hobbs R, McManus R. Benefits and harms of antihypertensive treatment in low-risk patients with mild hypertension.Published on 1 December 2018 JAMA Intern Med 2018;178:1626-34.This project was funded by a grant from the National Institute for Health Research (NIHR-RP-R2-12-O15) and the Medical Research Council (MRC) Strategic Skills Postdoctoral Fellowship.To read the full NIHR Signal, go to:
February 15, 2019: BMJ: British Medical Journal
Yan Li, Foram Jasani, Dejun Su, Donglan Zhang, Lizheng Shi, Stella S Yi, José A Pagán
OBJECTIVE: Nearly one-third of adults in New York City (NYC) have high blood pressure and many social, economic, and behavioral factors may influence nonadherence to antihypertensive medication. The objective of this study is to identify profiles of adults who are not taking antihypertensive medications despite being advised to do so. METHODS: We used a machine learning-based population segmentation approach to identify population profiles related to nonadherence to antihypertensive medication...
January 2019: Journal of Primary Care & Community Health
Selamawit Abebe, Walelegn Worku Yallew
OBJECTIVE: The objective of the research is to measure prevalence of hypertension and associated factors adult outpatient clients in Addis Ababa, Ethiopia. RESULTS: A total of 487 participants were included in the study. The prevalence of hypertension was (34.7%), 95% CI (30.6-38.8), of them 53.8 were Male and 46.2% were female. Among 169 participants identified as having high blood pressure, 131 (66.5%) were aware of their blood pressure, from those 96 (48.7%) of them were receiving antihypertensive medication...
February 14, 2019: BMC Research Notes
Michihiro Satoh, Takayoshi Ohkubo, Kei Asayama, Yoshitaka Murakami, Daisuke Sugiyama, Michiko Yamada, Shigeyuki Saitoh, Kiyomi Sakata, Fujiko Irie, Toshimi Sairenchi, Shizukiyo Ishikawa, Masahiko Kiyama, Hirofumi Ohnishi, Katsuyuki Miura, Yutaka Imai, Hirotsugu Ueshima, Tomonori Okamura
Lifetime risk (LTR) provides an absolute risk assessment during the remainder of one’s life. Few studies have focused on the LTRs of stroke and coronary heart disease (CHD), categorized by fine blood pressure in Asian populations. We aimed to assess it using a large database of a meta-analysis with the individual participant data. The present metaanalysis included 107 737 Japanese (42.4% men; mean age, 55.1 years) from 13 cohorts. During the mean follow-up of 15.2±5.3 years (1 559 136 person-years), 1922 died from stroke and 913 from CHD...
January 2019: Hypertension
Ting-Yu Chen, Chi-Wen Kao, Shu-Meng Cheng, Yue-Cune Chang
BACKGROUND: Medication titration has been used in home blood pressure (BP) control, with the expectation of enabling patients with hypertension to better manage their BP. OBJECTIVE: The study goal was to estimate the effects of medication titration intervention in lowering the systolic blood pressure and diastolic blood pressure of patients with hypertension. METHODS: The meta-analysis included randomized controlled trials on adults diagnosed with hypertension and BP≧130/80 mm Hg, having a medication-titration intervention, and using a home BP measurement...
March 2019: Medical Care
Qin Lu, Sheng-Ming Wang, Yi-Xiao Liu, Hong Chen, Rui Zhang, Wen-Hui Zhang, Yuan-Yuan Zou, Jia-Wei Zhou, Xin-Yi Guo, Ying Zhang, Teng-Li Huang, Yu-Hang Liu, Si-Qi Zhang, Kyosuke Yamanishi, Hiromichi Yamanishi, Hideaki Higashino, Haruki Okamura
Successful prevention and treatment of hypertension depend on the appropriate combination of antihypertensive drug therapy and nondrug lifestyle modification. While most hypertension guidelines recommend moderate- to high-intensity exercise, we decided to explore a mild yet effective type of exercise to add to hypertension management, especially in populations with complications or frailty. After comparing the short-term cardiovascular effects of low-speed walking versus high-speed walking for 3 kilometers (km) (3 km/h versus 6 km/h) in young, healthy volunteers, we delivered low-speed walking (low-intensity walking, 2...
February 13, 2019: Acta Pharmacologica Sinica
Kazuomi Kario, Eiichiro Yamamoto, Hirofumi Tomita, Takafumi Okura, Shigeru Saito, Takafumi Ueno, Daiki Yasuhara, Kazuyuki Shimada
BACKGROUND: SYMPLICITY HTN-Japan is a prospective, randomized, controlled trial comparing renal denervation (RDN) with standard pharmacologic therapy for treatment of uncontrolled hypertension (HTN). Methods and Results: Patients enrolled had uncontrolled HTN, defined as office systolic blood pressure (SBP) ≥160 mmHg and 24-h ambulatory SBP ≥135 mmHg, on ≥3 antihypertensive drugs of maximally tolerated dose for at least 6 weeks prior to enrollment. Randomization was 1:1 to RDN or maintenance of current medical therapy (control)...
February 13, 2019: Circulation Journal: Official Journal of the Japanese Circulation Society
Dan Pugh, Peter J Gallacher, Neeraj Dhaun
Chronic kidney disease (CKD) is an increasingly prevalent condition globally and is strongly associated with incident cardiovascular disease (CVD). Hypertension is both a cause and effect of CKD and affects the vast majority of CKD patients. Control of hypertension is important in those with CKD as it leads to slowing of disease progression as well as reduced CVD risk. Existing guidelines do not offer a consensus on optimal blood pressure (BP) targets. Therefore, an understanding of the evidence used to create these guidelines is vital when considering how best to manage individual patients...
February 13, 2019: Drugs
Tao Yang, Victor Aquino, Gilberto O Lobaton, Hongbao Li, Luis Colon-Perez, Ruby Goel, Yanfei Qi, Jasenka Zubcevic, Marcelo Febo, Elaine M Richards, Carl J Pepine, Mohan K Raizada
Background We have demonstrated that the antihypertensive effect of the angiotensin-converting enzyme inhibitor, captopril ( CAP ), is associated with beneficial effects on gut pathology. Coupled with the evidence that CAP exerts prolonged reduction in blood pressure ( BP ) after discontinuation of treatment, we investigate whether persistent beneficial actions of CAP are linked to alterations of gut microbiota and improvement of hypertension-induced gut pathology. Methods and Results Spontaneously hypertensive rats ( SHR ) and Wistar Kyoto rats were treated with CAP (250 mg/kg/day) for 4 weeks followed by withdrawal for 16 weeks...
February 19, 2019: Journal of the American Heart Association
Mai Mehanna, Zhiying Wang, Yan Gong, Caitrin W McDonough, Amber L Beitelshees, John G Gums, Arlene B Chapman, Gary L Schwartz, Kent R Bailey, Julie A Johnson, Stephen T Turner, Rhonda M Cooper-DeHoff
Background: Inter-individual variability in blood pressure (BP) response to antihypertensives has been reported. Although plasma renin activity (PRA) is a potential biomarker for personalizing antihypertensive therapy in European-American (EA) and African-American (AA) hypertensives, clinical utility of PRA-guided prescribing is incompletely understood. Methods: sing systematic-phased-approach, PRA's clinical utility was assessed. After categorizing by baseline-PRA, clinic systolic-BP (SBP) responses to metoprolol and chlorthalidone were compared in 134 EAs and 102 AAs enrolled in the Pharmacogenomics Evaluation of Antihypertensive Responses-2 (PEAR-2) trial...
February 9, 2019: American Journal of Hypertension
Marta Rojek, Marek W Rajzer, Wiktoria Wojciechowska, Tomasz Drożdż, Paweł Skalski, Tomasz Pizoń, Andrzej Januszewicz, Danuta Czarnecka
OBJECTIVE: To assess the impact of long-term exposure to aircraft noise on blood pressure (BP), prevalence of arterial hypertension, and indices of asymptomatic organ damage. METHODS: Using acoustic maps, we selected and further compared people living (average 35 years) in areas exposed to high, more than 60 dB (n = 101), and low aircraft noise, less than 55 dB (n = 100). Medical history taking, office BP measurement, ambulatory BP monitoring, and echocardiographic and arterial stiffness measurements were performed...
February 8, 2019: Journal of Hypertension
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
Huma Khan, Varun Jaiswal, Saurabh Kulshreshtha, Azhar Khan
BACKGROUND: Hypertension is the chronic medical condition and it affect billions of people worldwide. Natural medicines are the main alternatives of treatment for a large majority of people suffering from hypertension. Niazicin-A, Niazimin-A, and Niaziminin-B compounds were reported from Moringa oleifera ethanolic leave extract having potential antihypertensive activity. OBJECTIVE: These compounds targeted with Angiotensin-converting enzyme [ACE] which is one of the main regulatory enzymes of the renin-angiotensin system...
February 10, 2019: Recent Patents on Biotechnology
Wenbin Liu, Lizheng Shi, Monika Sawhney, Xiaoli Gu, Yingyao Chen
BACKGROUND: Evidence-based decision on drug list or formulary has been applied worldwide. Although the importance of scientific evidence was emphasized, the decision-making procedures for including medicines into the national reimbursement drug list were often challenged by their process opacity and relying on subjective expert opinion. This study aimed to explore and assess the evidence for the effectiveness of anti-hypertensive medicines included on the Chinese National Reimbursement Drug List (NRDL), and to provide recommendations for further improvement...
February 11, 2019: BMC Health Services Research
W H Feng, T T Yin, X H Chu, X D Shan, C Jiang, Y Wang, Y F Qian, Dalong Zhu, X T Sun, Yan Bi
AIM: To assess metabolic effects and safety of Roux-en-Y gastric bypass (RYGB) versus conventional medication (CM) in obese Chinese patients with type 2 diabetes (T2DM). METHODS: This retrospective cohort study included 40 patients who underwent RYGB (mean age 44.1 years, body mass index (BMI) 33.3 kg/m2 ) and 36 patients administered CM (mean age 49.4 years, BMI 32.1 kg/m2 ). The primary endpoint was achievement of the triple endpoint (hemoglobin A1C (HbA1c) <7...
February 10, 2019: Diabetes/metabolism Research and Reviews
Georgi Tchernev, Ivanka Temelkova
BACKGROUND: Melanoma appears to be a malignant disease, whose development can be potentiated by different drug groups. More and more data are in favour of the claim that commonly used antihypertensive drugs also contain the risk of developing melanoma. The most evidence is that angiotensin receptor blockers may be carcinogenic. Two representatives from this group, valsartan and irbesartan, produced by certain pharmaceutical companies are being withdrawn from the market due to finding content of NDMA and NDEA, which are believed to be potent carcinogens...
January 15, 2019: Open Access Macedonian Journal of Medical Sciences
Liliana C Baptista, Byron C Jaeger, Stephen D Anton, Anthony A Bavry, Eileen M Handberg, Anna K Gardner, Sara A Harper, Lisa M Roberts, Bhanuprasad Sandesara, Christy S Carter, Thomas W Buford
This pilot randomized controlled trial (RCT) was designed to provide the preliminary data necessary to conduct a full-scale trial to compare the efficacy of differing first-line antihypertensive medications in improving functional status in older adults, when combined with exercise. The primary objectives were to assess study feasibility, safety, and protocol integrity. Dependent outcomes included gait speed, exercise capacity, body composition, and systemic cardiometabolic biomarkers. Thirty-one physically inactive older adults (70...
February 6, 2019: Journal of Clinical Medicine
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