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hypertension guideline treatment

Giuseppe Mulè, Alessandra Sorce, Marta Giambrone, Brigida Fierro, Santina Cottone, Giovanni Cerasola
Intracerebral haemorrhage (ICH) is a devastating cerebrovascular disease, which accounts to 15% of all strokes. Among modifiable risk factors for ICH, hypertension is the most frequent. High blood pressure (BP) is detected in more than 75-80% of patients with ICH. Extremely elevated BP has been associated with early hematoma growth, a relatively frequent occurrence and powerful predictor of poor outcome in patients with spontaneous ICH. On the other hand, excessively low BP might cause cerebral hypoperfusion and ultimately lead to poor outcome...
February 18, 2019: High Blood Pressure & Cardiovascular Prevention: the Official Journal of the Italian Society of Hypertension
Luis Efrén Santos-Martínez, Víctor Manuel Lozano-Torres, César Antonio Flores-García, Patricia Soto-Márquez, Nielzer Armando Rodríguez-Almendros, Luis Raúl Meza-López, Jesús Zaín Campos-Larios, Moisés Cuttiel Calderón-Abbo
Background: Currently the options for treatment of chronic thromboembolic pulmonary hypertension can be pulmonary endarterectomy, pulmonary angioplasty and pharmacological treatment. Objective: To show the feasibility of performing pulmonary endarterectomy in a cardiology hospital. Methods: From December 2013 to June 2014 a serie of consecutive cases was studied according to the guidelines of the Fifth World Symposium of Pulmonary Hypertension...
January 28, 2019: Revista Médica del Instituto Mexicano del Seguro Social
Shanlee M Davis, Mitchell E Geffner
Individuals with Turner syndrome (TS) have a higher morbidity and mortality compared to the general population. Diabetes and cardiovascular disease are the major contributors to this burden. Precursors to diabetes and cardiovascular disease make up what is known as metabolic syndrome, including abdominal obesity, hypertension, dyslipidemia, and elevated fasting glucose. These features of poor cardiometabolic health are also prevalent among women with TS. Youth with TS also exhibit many of these features, indicating that the pathogenesis of these cardiometabolic conditions may begin early in life...
February 18, 2019: American Journal of Medical Genetics. Part C, Seminars in Medical Genetics
Raymond L Benza, Mardi Gomberg-Maitland, C Greg Elliott, Harrison W Farber, Aimee J Foreman, Adaani E Frost, Michael D McGoon, David J Pasta, Mona Selej, Charles D Burger, Robert P Frantz
BACKGROUND: Pulmonary arterial hypertension is a progressive, fatal disease. Published treatment guidelines recommend treatment escalation based on regular patient assessment with the goal of achieving or maintaining low-risk status. Various strategies are available to determine risk status. This analysis describes an update of the REVEAL risk calculator (REVEAL 2.0) and compares it with recently published ESC/ERS guidelines-derived risk assessment strategies. METHODS: A subpopulation from the U...
February 14, 2019: Chest
F Mahfoud, M Böhm, C M Bongarth, R Bosch, R E Schmieder, H Schunkert, C Stellbrink, P Trenkwalder, O Vonend, J Weil, R Kreutz
Arterial hypertension represents one of the most frequent chronic diseases that can lead to complications, such as stroke, dementia, heart attack, heart failure and renal failure. By 2025 the number of hypertensive patients will increase to approximately 1.6 billion people worldwide. The new guidelines of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH) on the management of arterial hypertension replace the guidelines of the ESC/ESH from 2013. The 2018 guidelines of the ESC/ESH were adopted by the German Cardiac Society and the German Hypertension League...
February 15, 2019: Der Internist
Dominique Thabut, Christophe Bureau, Richard Layese, Valérie Bourcier, Maryam Hammouche, Carole Cagnot, Patrick Marcellin, Dominique Guyader, Stanislas Pol, Dominique Larrey, Victor De Lédinghen, Denis Ouzan, Fabien Zoulim, Dominique Roulot, Albert Tran, Jean-Pierre Bronowicki, Jean-Pierre Zarski, Odile Goria, Paul Calès, Jean-Marie Péron, Laurent Alric, Marc Bourlière, Philippe Mathurin, Jean-Frédéric Blanc, Armand Abergel, Lawrence Serfaty, Ariane Mallat, Jean-Didier Grangé, Pierre Attali, Yannick Bacq, Claire Wartelle-Bladou, Thông Dao, Christophe Pilette, Christine Silvain, Christos Christidis, Dominique Capron, Brigitte Bernard-Chabert, Sophie Hillaire, Vincent Di Martino, Angela Sutton, Etienne Audureau, Françoise Roudot-Thoraval, Pierre Nahon, Pierre Nahon, Patrick Marcellin, Dominique Guyader, Stanislas Pol, Hélène Fontaine, Dominique Larrey, Victor De Lédinghen, Denis Ouzan, Fabien Zoulim, Dominique Roulot, Albert Tran, Jean-Pierre Bronowicki, Jean-Pierre Zarski, Vincent Leroy, Ghassan Riachi, Paul Calès, Jean-Marie Péron, Laurent Alric, Marc Bourlière, Philippe Mathurin, Sebastien Dharancy, Jean-Frédéric Blanc, Armand Abergel, Lawrence Serfaty, Ariane Mallat, Jean-Didier Grangé, Pierre Attali, Yannick Bacq, Claire Wartelle, Thông Dao, Dominique Thabut, Christophe Pilette, Christine Silvain, Christos Christidis, Dominique Capron, Gérard Thiefin, Sophie Hillaire, Vincent Di Martino
BACKGROUND & AIMS: Management of patients with cirrhosis includes endoscopic screening and surveillance to detect esophageal varices (EV) and prevent bleeding. However, the Baveno VI guidelines recommend avoiding endoscopies for patients with liver stiffness measurements below 20 kPa and platelet counts above 150,000 (favorable Baveno VI status) and endoscopic assessment of patients with higher levels of liver stiffness and platelet counts (unfavorable Baveno VI status). We aimed to validate the Baveno VI guidelines, evaluating outcomes of patients in the ANRS-CO12 CirVir cohort with compensated cirrhosis associated with hepatitis B virus (HBV) or hepatitis C virus (HCV) infection, with or without a sustained response to antiviral therapy...
February 12, 2019: Gastroenterology
Aura A Sanchez Mejia, Nathan J Rodgers
PURPOSE OF REVIEW: This review aims to describe the assessment of pulmonary hypertension and ventricular function in neonates with congenital diaphragmatic hernia and the long-term follow-up of their pulmonary vascular disease. RECENT FINDINGS: In 2015, the pediatric pulmonary hypertension guidelines from the American Heart Association and American Thoracic Society suggested class I level of evidence B guidelines for routine evaluation of patients with congenital diaphragmatic hernia, including longitudinal care in an interdisciplinary pulmonary hypertension program and following the recommendations offered for all children with pulmonary hypertension...
February 15, 2019: Current Treatment Options in Cardiovascular Medicine
Deborah I Friedman
BACKGROUND: Headache is the most common symptom of idiopathic intracranial hypertension (IIH) and may not resolve with intracranial pressure-lowering treatments. Many patients with IIH have a pre-existing history of migraine. Approximately two-thirds of patients with IIH continue to experience headaches after the other manifestations of the disorder resolve. There are no evidence-based guidelines for treating IIH-related headaches. EVIDENCE ACQUISITION: This review proposes mechanisms by which IIH produces both acute and ongoing headache...
March 2019: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
Bethany Roehm, Daniel E Weiner
PURPOSE OF REVIEW: Hypertension is highly prevalent in the United States and a major risk factor for the development of cardiovascular disease. Hypertension is common in chronic kidney disease (CKD), and likely contributes to the association between CKD and cardiovascular disease. The ideal systolic BP to reduce cardiovascular disease risk in individuals with CKD is controversial. RECENT FINDINGS: Several societies have released guidelines on the treatment of hypertension in the past year, each differing in important aspects, including BP targets...
February 12, 2019: Current Opinion in Nephrology and Hypertension
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
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
Jorge H Ulloa
Chronic venous disease (CVD) is both prevalent and unavoidable in many people as a result of persistent or unalterable risk factors, the most important of which are advanced age, excess body weight, and family history. Given this inevitability, medical treatment is required to alleviate symptoms and slow disease progression. Venoactive drug therapy is emerging as a valuable treatment option for many CVD patients and micronized purified flavonoid fraction (MPFF) is the most widely prescribed and well-studied venoactive drug available...
February 13, 2019: Advances in Therapy
J Bolon, K McCutcheon, E Klug, D Smith, P Manga
BACKGROUND: Despite the significant clinical benefits of beta-blockers in heart failure with reduced ejection fraction (HFrEF), prescription for and adherence to these agents is reported to be poor. There are few data on the use and tolerance of beta-blocker therapy in patients with HFrEF in South Africa and it is unknown whether these patients would benefit from further heart rate-lowering therapy. METHODS: Data from all patients with HFrEF attending the heart failure clinic of Charlotte Maxeke Johannesburg Academic Hospital from January 2000 to December 2014 were retrospectively collected...
February 11, 2019: Cardiovascular Journal of Africa
Yanhuan Feng, Rongshuang Huang, Janet Kavanagh, Lingzhi Li, Xiaoxi Zeng, Yi Li, Ping Fu
INTRODUCTION: Current guidelines recommend renin-angiotensin-aldosterone system (RAAS) inhibitors in the treatment of diabetic kidney disease (DKD). However, evidence suggests that the combined use of RAAS blockers may be associated with increased rates of adverse events. OBJECTIVES: Our objective was to examine the efficacy and safety of dual blockade of the RAAS in patients with DKD. METHODS: This was a systematic review and meta-analysis of randomized controlled trials (RCTs) published between January 1990 and January 2018 sourced via the PubMed, EMBASE, and Cochrane Library databases...
February 9, 2019: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
Susheel P Patil, Indu A Ayappa, Sean M Caples, R John Kimoff, Sanjay R Patel, Christopher G Harrod
INTRODUCTION: This guideline establishes clinical practice recommendations for positive airway pressure (PAP) treatment of obstructive sleep apnea (OSA) in adults and is intended for use in conjunction with other American Academy of Sleep Medicine (AASM) guidelines in the evaluation and treatment of sleep-disordered breathing in adults. METHODS: The AASM commissioned a task force of experts in sleep medicine. A systematic review was conducted to identify studies, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) process was used to assess the evidence...
February 4, 2019: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Fabio Angeli, Gianpaolo Reboldi, Monica Trapasso, Giorgio Gentile, Maria Gabriella Pinzagli, Adolfo Aita, Paolo Verdecchia
Hypertension is one of the most common chronic diseases in adults and a leading cause of disability and mortality worldwide. Recently, new Guidelines for the diagnosis and management of hypertension have been released in Europe and in the United States, with changes regarding how to diagnose and treat the condition, and the extent to which intensive blood pressure control should be pursued. Important differences between the Guidelines exist in the classification of blood pressure levels and definition of treatment goals...
February 4, 2019: European Journal of Internal Medicine
Mevlut Albayrak, Alptug Atıla, Elif Yılmazel Ucar, Omer Araz, Yucel Kadıoglu
Macitentan is an endothelin receptor antagonist commonly used in the treatment of pulmonary arterial hypertension (PAH). A novel, rapid, simple and sensitive UPLC-MS/MS method was developed and validated for pharmacokinetic study and the determination of macitentan in PAH patients. Macitentan and bosentan which is used as internal standard were detected using APCI in positive ion and MRM mode by monitoring the mass transitions m/z 589.1→203.3 and 552.6→311.5, respectively. Chromatographic separation was performed on reverse phase C18 column (5 μm, 4...
February 6, 2019: Biomedical Chromatography: BMC
Jueli Wu, Wenqing Tian, Lu Zhang, Jiao Zhang, Bo Zhou
OBJECTIVE: To review the validity and applicability of clinical guidelines on the management of primary aldosteronism and to list their discrepancies to allow health-care providers and guideline developers to make informed decisions. DESIGN AND METHODS: Primary aldosteronism management guidelines, including specialist, subgroup, general guidelines written in English, were obtained from electronic databases. Appraisers independently extracted the data, and used the Appraisal Guidelines Research and Evaluation II (AGREE-II) tool and the Institute of Medicine (IOM) criteria to independently evaluate the methodological quality of the guidelines...
February 4, 2019: Journal of Hypertension
Jutta Bergler-Klein
The new guidelines on hypertension of the European Society of Cardiology (ESC) 2018 have refined the treatment cut-offs and therapy decisions in adults. This review highlights important recommendations of the guidelines and also on the situation of hypertension in Austria. The general treatment targets of blood pressure have been lowered to at least 130/80 mmHg for most patients. The definition of hypertension is specified as a repeated systolic blood pressure in the office of ≥140 and or diastolic BP ≥90 mmHg...
February 4, 2019: Wiener Klinische Wochenschrift
C A Stuenkel
Over the past decades, progress in efforts to reduce cardiovascular morbidity and mortality has been achieved, although a disturbing trend for stagnation of cardiovascular mortality rates among younger women compared with those in younger men has been identified. While the menopause transition has traditionally offered an unequivocal opportunity to assess cardiovascular risk and counsel women to adopt preventive strategies, the veritable 'window of opportunity', usually applied to the concept of timing the initiation of menopausal hormone therapy, must be opened much wider to encompass younger women including those who have experienced adverse events during pregnancy, treatment for breast cancer, and premature menopause...
February 4, 2019: Climacteric: the Journal of the International Menopause Society
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