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Arterial hypertension guideline diabetes treatment

Diana Jurić, Ivančica Pavličević, Ana Marušić, Mario Malički, Ivan Buljan, Velen Šarotić, Nataša Mrduljaš-Đujić, Ante Komparak, Miona Vujević, Danijela De Micheli-Vitturi, Pjera Šušnjar, Tina Puljiz, Minka Jerčić, Dario Leskur, Matko Marušić
BACKGROUND: Uncontrolled blood pressure remains an urgent issue in clinical practice worldwide. This study aimed to compare the characteristics and effectiveness of hypertension control in family medicine pratice in the first treatment year, in relation to the geographical position, socio-economic standard, and access to medical services and public pharmacies in urban, rural and island environments (city of Split vs. Dalmatian Hinterland vs. islands in Southern Croatia). METHODS: A historical cohort study included 213 patients diagnosed from 2008 to 2014 with essential arterial hypertension (AH) and without related complications or diabetes mellitus...
January 14, 2019: BMC Family Practice
Sang-Hyun Ihm, George Bakris, Ichiro Sakuma, Il Suk Sohn, Kwang Kon Koh
Until the 2017 ACC/AHA Hypertension Guidelines were released, the target blood pressure (BP) for adults with hypertension (HTN) was 140/90 mmHg in most of the guidelines. The new 2018 ESC/ESH, Canadian, Korean, Japan, and Latin American hypertension guidelines have maintained the <140/90 mmHg for the primary target in the general population and encourage reduction to <130/80 if higher risk. This is more in keeping with the 2018 American Diabetes Association guidelines. However, the 2017 ACC/AHA guidelines classify HTN as BP ≥130/80 mmHg and generally recommend target BP levels below 130/80 mmHg for hypertensive patients independently of comorbid disease or age...
December 29, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
Francesco Vitali, Matteo Serenelli, Juhani Airaksinen, Rita Pavasini, Anna Tomaszuk-Kazberuk, Elzbieta Mlodawska, Samuli Jaakkola, Cristina Balla, Lorenzo Falsetti, Nicola Tarquinio, Roberto Ferrari, Angelo Squeri, Gianluca Campo, Matteo Bertini
BACKGROUND: Despite progresses in the treatment of the thromboembolic risk related to atrial fibrillation (AF), the management of recurrences remains a challenge. HYPOTHESIS: to assess if CHA2 DS2 -VASc score is predictive of early arrhythmia recurrence after AF cardioversion. METHODS: Systematic review and individual patient pooled meta-analysis following PRISMA guidelines. INCLUSION CRITERIA: observational trials in patients with AF undergoing cardioversion, available data on recurrence of AF and available data on CHA2 DS2 -VASc score...
December 30, 2018: Clinical Cardiology
Juan Fdez-Olivares, Eva Onaindia, Luis Castillo, Jaume Jordán, Juan Cózar
The conciliation of multiple single-disease guidelines for comorbid patients entails solving potential clinical interactions, discovering synergies in the diagnosis and the recommendations, and managing clinical equipoise situations. Personalized conciliation of multiple guidelines considering additionally patient preferences brings some further difficulties. Recently, several works have explored distinct techniques to come up with an automated process for the conciliation of clinical guidelines for comorbid patients but very little attention has been put in integrating the patient preferences into this process...
November 22, 2018: Artificial Intelligence in Medicine
Lyudmyla N Prystupa, Irina O Moiseyenko, Victoria Yu Garbuzova, Vladyslava V Kmyta, Irina A Dudchenko
OBJECTIVE: Introduction: All components of the metabolic syndrome (MS) are the risk factors for the cardiovascular diseases, and their combination a great deal accelerates and complicates development of the diseases. Phenotypic expression of MS depends on the interaction of genetic and environmental factors. The aim: The aim is to study the association of metabolic syndrome components with the genotypes of the C825T polymorphism in the GNB3 gene, which allows predicting the risks and determining individual lifestyle and treatment program for the future...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
Giulia Borghetti, Dirk von Lewinski, Deborah M Eaton, Harald Sourij, Steven R Houser, Markus Wallner
Diabetes mellitus and the associated complications represent a global burden on human health and economics. Cardiovascular diseases are the leading cause of death in diabetic patients, who have a 2-5 times higher risk of developing heart failure than age-matched non-diabetic patients, independent of other comorbidities. Diabetic cardiomyopathy is defined as the presence of abnormal cardiac structure and performance in the absence of other cardiac risk factors, such coronary artery disease, hypertension, and significant valvular disease...
2018: Frontiers in Physiology
Gerd Hasenfuß
Prevention strategies for cardiac events depend of the risk for such an event. A very high risk is defined by a risk >10% over 10 years. For example, a patient with known coronary artery disease has such a very high risk to die. However a patient with diabetes and severe hypertension without known coronary artery disease carries the same risk. Here, secondary prevention and primary prevention overlap. Prevention guidelines include a number of general recommendations such as changes in behavior, smoking intervention strategies, nutrition, body weight, and physical activity...
October 19, 2018: Kardiologia Polska
Brent Egan, John Flack, Mehul Patel, Sofia Lombera
A quantitative survey was completed by 103 primary care physicians (PCPs) and 59 cardiologists who regularly prescribed β-blockers to assess knowledge and use of this heterogeneous drug class for hypertension. More cardiologists than PCPs chose β-blockers as initial antihypertensive therapy (30% vs 17%, P < 0.01). Metoprolol and carvedilol were the most commonly prescribed β-blockers. Cardiologists rated "impact on energy" and "arterial vasodilation" as more important than PCPs (P < 0...
October 2018: Journal of Clinical Hypertension
Allison L Kuipers, Iva Miljkovic, Emma Barinas-Mitchell, Ryan Cvejkus, Clareann H Bunker, Victor W Wheeler, Joseph M Zmuda
OBJECTIVE: African ancestry individuals are at high risk for hypertensive cardiovascular disease (CVD) and could benefit from early detection of arterial stiffening. We tested the association between the 2017 ACC/AHA hypertension categorizations, which include new blood pressure (BP) cutoffs and a definition for elevated BP, and arterial stiffness in 772 Afro-Caribbean men aged 50+ years (mean 64 years). METHODS: Arterial stiffness was assessed by brachial-ankle pulse-wave velocity (PWV) using a waveform analyzer...
September 17, 2018: Journal of Hypertension
Jens Jordan, Christine Kurschat, Hannes Reuter
BACKGROUND: Essential arterial hypertension is one of the main treatable cardiovascular risk factors. In Germany, approximately 13% of women and 18% of men have uncontrolled high blood pressure (≥ 140/90 mmHg). METHODS: This review is based on pertinent publications retrieved by a selective literature search in PubMed. RESULTS: Arterial hypertension is diagnosed when repeated measurements in a doctor's office yield values of 140/90 mmHg or higher...
August 20, 2018: Deutsches Ärzteblatt International
Katarzyna Skórkowska-Telichowska, Katarzyna Kropielnicka, Katarzyna Bulińska, Urszula Pilch, Marek Woźniewski, Andrzej Szuba, Ryszard Jasiński
BACKGROUND: An aggressive reduction of cardiovascular risk factors in patients with intermittent claudication (IC) is extremely important. OBJECTIVES: The aim of this study was to investigate patients' adherence to current guidelines for the recognition and reduction of atherosclerosis risk factors in peripheral arterial disease (PAD) in Poland. MATERIAL AND METHODS: The study included 126 patients with PAD stage II, according to the Fontaine Classification, who over a period of 2 years attended an angiological outpatient clinic and were referred for physical rehabilitation...
June 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Jordan D Awerbach, Richard A Krasuski, Michael G W Camitta
There are >1.4 million adult congenital heart disease (CHD; ACHD) patients living in the United States. Coronary artery disease (CAD) is at least as prevalent in ACHD patients as in the general population and has become a leading cause of their mortality. In the majority of cases, CAD in the ACHD population is driven by the presence of traditional cardiovascular disease (CVD) risk factors. 80% of ACHD patients have at least one CVD risk factor. Hypertension (HTN), obesity and physical inactivity are frequently seen in both pediatric and adult patients with CHD...
July 21, 2018: Progress in Cardiovascular Diseases
Monica Mu, Sandawana William Majoni, Pupalan Iyngkaran, Mark Haste, Nadarajah Kangaharan
BACKGROUND: Heart failure (HF) is associated with significant morbidity and mortality and recurrent hospitalisations, particularly in the Indigenous Australians of the Northern Territory. In remote Northern Australia, the epidemiology is less clear but anecdotal evidence suggests it may be worse. In addition, some anecdotal evidence suggests that prognostic pharmacological therapy could also be underutilised. Minimal HF data exists in the remote and Indigenous settings, making this study unique...
June 19, 2018: Heart, Lung & Circulation
Michael Khoury, Philip R Khoury, Lawrence M Dolan, Thomas R Kimball, Elaine M Urbina
BACKGROUND AND OBJECTIVES: New pediatric hypertension definitions were recently published in a clinical practice guideline (CPG). We evaluated the impact of the CPG, compared with the previous guideline ("Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents"), on the prevalence of hypertension and associations with target organ damage (TOD) in high-risk youth. METHODS: Participants (10-18 years old) undergoing an evaluation of the cardiovascular effects of obesity and type 2 diabetes mellitus in youth were studied...
August 2018: Pediatrics
Nathan K Itoga, Daniel S Tawfik, Charles K Lee, Satoshi Maruyama, Nicholas J Leeper, Tara I Chang
BACKGROUND: Current guidelines recommend treating hypertension in patients with peripheral artery disease (PAD) to reduce the risk of cardiac events and stroke, but the effect of reducing blood pressure on lower extremity PAD events is largely unknown. We investigated the association of blood pressure with lower extremity PAD events using data from the ALLHAT trial (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial). METHODS: ALLHAT investigated the effect of different antihypertensive medication classes (chlorthalidone, amlodipine, lisinopril, or doxazosin) on cardiovascular events...
October 23, 2018: Circulation
Josep Maria Pepió Vilaubí, Domingo Orozco-Beltrán, Alessandra Queiroga Gonçalves, Dolors Rodriguez Cumplido, Carina Aguilar Martin, Adriana Lopez-Pineda, Vicente F Gil-Guillen, Jose A Quesada, Concepcion Carratala-Munuera
To provide a better understanding of the actions taken within health systems and their results, this study aims to assess clinicians&rsquo; adherence to clinical practice guidelines regarding recommended treatments in patients with cardiovascular disease in primary care settings, and to determine the associated factors. We conducted an ambispective cohort study in 21 primary care centres in 8 Spanish regions. Patients diagnosed with coronary heart disease, stroke and/or peripheral arterial disease were included...
June 11, 2018: International Journal of Environmental Research and Public Health
Raija Lithovius, Daniel Gordin, Carol Forsblom, Markku Saraheimo, Valma Harjutsalo, Per-Henrik Groop
AIMS/HYPOTHESIS: This study aimed to assess the use of ambulatory BP monitoring (ABPM) to identify the presence of masked, nocturnal and white-coat hypertension in individuals with type 1 diabetes, patterns that could not be detected by regular office-based BP monitoring alone. We also analysed associations between BP patterns and arterial stiffness in order to identify individuals at cardiovascular risk. METHODS: This substudy included 140 individuals with type 1 diabetes from the Helsinki metropolitan area, who attended the Finnish Diabetic Nephropathy Study (FinnDiane) Centre in Helsinki between January 2013 and August 2017...
September 2018: Diabetologia
M Mahendra, Sunil Kumar S, Nagaraj Desai, Jayaraj Bs, Mahesh Pa
BACKGROUND: Ischemic heart disease (IHD) and chronic airway disease (COPD and Asthma) are major epidemics accounting for significant mortality and morbidity. The combination presents many diagnostic challenges. Clinical symptoms and signs frequently overlap. There is a need for airway evaluation in these patients to plan appropriate management. METHODS: Consecutive stable IHD patients attending the cardiology OPD in a tertiary care centre were interviewed for collecting basic demographic information, brief medical, occupational, personal history and risk factors for coronary artery disease and airway disease, modified medical research centre (MMRC) grade for dyspnea, quality of life-St...
March 2018: Indian Heart Journal
Mallory L Downie, Emma H Ulrich, Damien G Noone
The prevalence of hypertension in children with type 1 diabetes is reported to be between 6% and 16%. This potentially modifiable cardiovascular risk factor may go undiagnosed and undertreated, particularly in children with type 1 diabetes. Recent updated Canadian clinical practice guidelines recommend blood pressure screening every 2 years in children with type 1 diabetes as well as routine use of ambulatory blood pressure monitoring. Risk factors for hypertension in type 1 diabetes include poor glycemic control, overweight and obesity and genetic predisposition for hypertension...
April 2018: Canadian Journal of Diabetes
Wilbert S Aronow, William H Frishman
The 2017 American College of Cardiology/American Heart Association hypertension guidelines diagnose hypertension if systolic blood pressure (SBP) is ≥ 130 mmHg or diastolic blood pressure (DBP) is ≥ 80 mmHg. Increased BP is SBP 120-129 mmHg with DBP < 80 mmHg. Lifestyle measures should be used to treat individuals with increased BP. Lifestyle measures plus BP-lowering drugs should be used for secondary prevention of recurrent cardiovascular events in individuals with clinical cardiovascular disease (coronary heart disease, congestive heart failure, or stroke) and an average SBP ≥ 130 mmHg or an average DBP ≥ 80 mmHg...
April 2018: Drugs
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