collection
https://read.qxmd.com/read/26551272/a-randomized-trial-of-intensive-versus-standard-blood-pressure-control
#21
RANDOMIZED CONTROLLED TRIAL
Jackson T Wright, Jeff D Williamson, Paul K Whelton, Joni K Snyder, Kaycee M Sink, Michael V Rocco, David M Reboussin, Mahboob Rahman, Suzanne Oparil, Cora E Lewis, Paul L Kimmel, Karen C Johnson, David C Goff, Lawrence J Fine, Jeffrey A Cutler, William C Cushman, Alfred K Cheung, Walter T Ambrosius
BACKGROUND: The most appropriate targets for systolic blood pressure to reduce cardiovascular morbidity and mortality among persons without diabetes remain uncertain. METHODS: We randomly assigned 9361 persons with a systolic blood pressure of 130 mm Hg or higher and an increased cardiovascular risk, but without diabetes, to a systolic blood-pressure target of less than 120 mm Hg (intensive treatment) or a target of less than 140 mm Hg (standard treatment). The primary composite outcome was myocardial infarction, other acute coronary syndromes, stroke, heart failure, or death from cardiovascular causes...
November 26, 2015: New England Journal of Medicine
https://read.qxmd.com/read/26553785/managing-hypertension-in-patients-with-ckd-a-marathon-not-a-sprint
#22
JOURNAL ARTICLE
Glenn M Chertow, Srinivasan Beddhu, Julia B Lewis, Robert D Toto, Alfred K Cheung
In this manuscript, nephrologist-investigators from one of five Clinical Center Networks of the Systolic Blood Pressure Intervention Trial (SPRINT) provide background information and context on the intensity of anti-hypertensive therapy in conjunction with the release of detailed results from SPRINT's primary analysis. The authors highlight published evidence on the safety and efficacy of differing intensities of anti-hypertensive therapy in mild to moderate CKD, where SPRINT will help to inform practice, as well as where gaps in evidence will remain...
January 2016: Journal of the American Society of Nephrology: JASN
https://read.qxmd.com/read/26174784/orthostatic-hypotension-mechanisms-causes-management
#23
REVIEW
Phillip A Low, Victoria A Tomalia
Orthostatic hypotension (OH) occurs when mechanisms for the regulation of orthostatic BP control fails. Such regulation depends on the baroreflexes, normal blood volume, and defenses against excessive venous pooling. OH is common in the elderly and is associated with an increase in mortality rate. There are many causes of OH. Aging coupled with diseases such as diabetes and Parkinson's disease results in a prevalence of 10-30% in the elderly. These conditions cause baroreflex failure with resulting combination of OH, supine hypertension, and loss of diurnal variation of BP...
July 2015: Journal of Clinical Neurology
https://read.qxmd.com/read/11136953/effects-on-blood-pressure-of-reduced-dietary-sodium-and-the-dietary-approaches-to-stop-hypertension-dash-diet-dash-sodium-collaborative-research-group
#24
RANDOMIZED CONTROLLED TRIAL
F M Sacks, L P Svetkey, W M Vollmer, L J Appel, G A Bray, D Harsha, E Obarzanek, P R Conlin, E R Miller, D G Simons-Morton, N Karanja, P H Lin
BACKGROUND: The effect of dietary composition on blood pressure is a subject of public health importance. We studied the effect of different levels of dietary sodium, in conjunction with the Dietary Approaches to Stop Hypertension (DASH) diet, which is rich in vegetables, fruits, and low-fat dairy products, in persons with and in those without hypertension. METHODS: A total of 412 participants were randomly assigned to eat either a control diet typical of intake in the United States or the DASH diet...
January 4, 2001: New England Journal of Medicine
https://read.qxmd.com/read/25832858/hypertension
#25
REVIEW
Neil R Poulter, Dorairaj Prabhakaran, Mark Caulfield
Raised blood pressure is the biggest single contributor to the global burden of disease and to global mortality. The numbers of people affected and the prevalence of high blood pressure worldwide are expected to increase over the next decade. Preventive strategies are therefore urgently needed, especially in less developed countries, and management of hypertension must be optimised. Genetic advances in some rare causes of hypertension have been made lately, but the aggregate effect on blood pressure of all the genetic loci identified to date is small...
August 22, 2015: Lancet
https://read.qxmd.com/read/25653099/assessment-and-management-of-hypertension-in-transplant-patients
#26
REVIEW
Matthew R Weir, Ellen D Burgess, James E Cooper, Andrew Z Fenves, David Goldsmith, Dianne McKay, Anita Mehrotra, Mark M Mitsnefes, Domenic A Sica, Sandra J Taler
Hypertension in renal transplant recipients is common and ranges from 50% to 80% in adult recipients and from 47% to 82% in pediatric recipients. Cardiovascular morbidity and mortality and shortened allograft survival are important consequences of inadequate control of hypertension. In this review, we examine the epidemiology, pathophysiology, and management considerations of post-transplant hypertension. Donor and recipient factors, acute and chronic allograft injury, and immunosuppressive medications may each explain some of the pathophysiology of post-transplant hypertension...
June 2015: Journal of the American Society of Nephrology: JASN
https://read.qxmd.com/read/25416665/treatment-resistant-hypertension-in-the-transplant-recipient
#27
REVIEW
Jay I Lakkis, Matthew R Weir
Treatment-resistant hypertension (TRH) is defined as follows: (1) the failure to achieve optimal blood pressure control to levels less than 140/90 mm Hg despite the concomitant use of 3 or more different classes of antihypertensive agents, one of which is a diuretic, or (2) the simultaneous use of 4 or more different classes of antihypertensive agents in a patient irrespective of blood pressure control and the exclusion of pseudoresistance. Patients with TRH constitute only a subset of patients with poorly controlled hypertension, which also includes other subsets of patients who are treated inadequately or who are noncompliant with prescribed pharmacologic and nonpharmacologic therapy...
2014: Seminars in Nephrology
https://read.qxmd.com/read/25583291/a-patient-with-acute-kidney-pain-and-high-blood-pressure
#28
JOURNAL ARTICLE
Debbie L Cohen, Michael C Soulen
This case presented challenging diagnostic and management issues in a young healthy man who presented with abdominal pain and new-onset hypertension. The differential diagnosis evolved over the course of the clinical presentation. The patient had severe vascular involvement of his renal and basal cerebral arteries that initially was assumed to be due to a vasculitic process or hypercoagulable state. Finally it became apparent that the patient did not have a systemic illness but rather a localized vascular disease most likely due to segmental arterial mediolysis, a rare, under-recognized condition that can potentially be fatal...
April 7, 2015: Clinical Journal of the American Society of Nephrology: CJASN
https://read.qxmd.com/read/25531552/effects-of-blood-pressure-reduction-in-mild-hypertension-a-systematic-review-and-meta-analysis
#29
REVIEW
Johan Sundström, Hisatomi Arima, Rod Jackson, Fiona Turnbull, Kazem Rahimi, John Chalmers, Mark Woodward, Bruce Neal
BACKGROUND: Effects of blood pressure reduction in persons with grade 1 hypertension are unclear. PURPOSE: To investigate whether pharmacologic blood pressure reduction prevents cardiovascular events and deaths in persons with grade 1 hypertension. DATA SOURCES: Trials included in the BPLTTC (Blood Pressure Lowering Treatment Trialists' Collaboration) and trials identified from a previous review and electronic database searches. STUDY SELECTION: Patients without cardiovascular disease with blood pressures in the grade 1 hypertension range (140 to 159/90 to 99 mm Hg) who were randomly assigned to an active (antihypertensive drug or more intensive regimen) or control (placebo or less intensive regimen) blood pressure-lowering regimen...
February 3, 2015: Annals of Internal Medicine
https://read.qxmd.com/read/25531400/diagnostic-and-predictive-accuracy-of-blood-pressure-screening-methods-with-consideration-of-rescreening-intervals-a-systematic-review-for-the-u-s-preventive-services-task-force
#30
REVIEW
Margaret A Piper, Corinne V Evans, Brittany U Burda, Karen L Margolis, Elizabeth O'Connor, Evelyn P Whitlock
BACKGROUND: Elevated blood pressure (BP) is the largest contributing risk factor to all-cause and cardiovascular mortality. PURPOSE: To update a systematic review on the benefits and harms of screening for high BP in adults and to summarize evidence on rescreening intervals and diagnostic and predictive accuracy of different BP methods for cardiovascular events. DATA SOURCES: Selected databases searched through 24 February 2014. STUDY SELECTION: Fair- and good-quality trials and diagnostic accuracy and cohort studies conducted in adults and published in English...
February 3, 2015: Annals of Internal Medicine
https://read.qxmd.com/read/25016398/the-impact-of-sodium-and-potassium-on-hypertension-risk
#31
REVIEW
Horacio J Adrogué, Nicolaos E Madias
The pathogenic role of sodium surfeit in primary hypertension is widely recognized but that of potassium deficiency usually has been ignored or at best assigned subsidiary status. Weighing the available evidence, we recently proposed that the chief environmental factor in the pathogenesis of primary hypertension and the associated cardiovascular risk is the interaction of the sodium surfeit and potassium deficiency in the body. Here, we present the major evidence highlighting the relationship between high-sodium intake and hypertension...
May 2014: Seminars in Nephrology
https://read.qxmd.com/read/25247329/hypertension-is-it-time-to-reconsider-blood-pressure-guidelines
#32
COMMENT
Anna Burgner, Julia B Lewis
No abstract text is available yet for this article.
November 2014: Nature Reviews. Nephrology
https://read.qxmd.com/read/25092599/a-young-patient-with-a-family-history-of-hypertension
#33
JOURNAL ARTICLE
Aldo J Peixoto
The evaluation of causes of hypertension in young adults with a family history of hypertension needs to be methodical to identify potentially treatable causes. Renal- and renovascular imaging and measurement of plasma aldosterone and plasma renin activity are at the core of this evaluation in most patients. Pertinent aspects of hypertension in autosomal dominant polycystic kidney disease are discussed with a focus on the role of the endothelium in mediating early hypertension and a review of treatment strategies...
December 5, 2014: Clinical Journal of the American Society of Nephrology: CJASN
https://read.qxmd.com/read/25157723/effect-of-self-monitoring-and-medication-self-titration-on-systolic-blood-pressure-in-hypertensive-patients-at-high-risk-of-cardiovascular-disease-the-tasmin-sr-randomized-clinical-trial
#34
RANDOMIZED CONTROLLED TRIAL
Richard J McManus, Jonathan Mant, M Sayeed Haque, Emma P Bray, Stirling Bryan, Sheila M Greenfield, Miren I Jones, Sue Jowett, Paul Little, Cristina Penaloza, Claire Schwartz, Helen Shackleford, Claire Shovelton, Jinu Varghese, Bryan Williams, F D Richard Hobbs, Trevor Gooding, Ian Morrey, Crispin Fisher, David Buckley
IMPORTANCE: Self-monitoring of blood pressure with self-titration of antihypertensives (self-management) results in lower blood pressure in patients with hypertension, but there are no data about patients in high-risk groups. OBJECTIVE: To determine the effect of self-monitoring with self-titration of antihypertensive medication compared with usual care on systolic blood pressure among patients with cardiovascular disease, diabetes, or chronic kidney disease. DESIGN, SETTING, AND PATIENTS: A primary care, unblinded, randomized clinical trial involving 552 patients who were aged at least 35 years with a history of stroke, coronary heart disease, diabetes, or chronic kidney disease and with baseline blood pressure of at least 130/80 mm Hg being treated at 59 UK primary care practices was conducted between March 2011 and January 2013...
August 27, 2014: JAMA
https://read.qxmd.com/read/25173681/association-of-treatment-with-carvedilol-vs-metoprolol-succinate-and-mortality-in-patients-with-heart-failure
#35
COMPARATIVE STUDY
Björn Pasternak, Henrik Svanström, Mads Melbye, Anders Hviid
IMPORTANCE: The β-blockers carvedilol and metoprolol succinate both reduce mortality in patients with heart failure (HF), but the comparative clinical effectiveness of these drugs is unknown. OBJECTIVE: To investigate whether carvedilol is associated with improved survival compared with metoprolol succinate. DESIGN, SETTING, AND PARTICIPANTS: Cohort study of patients with incident HF with reduced left ventricular ejection fraction (LVEF) (≤40%) who received carvedilol (n = 6026) or metoprolol succinate (n = 5638) using data from a Danish national HF registry linked with health care and administrative databases...
October 2014: JAMA Internal Medicine
https://read.qxmd.com/read/25016400/comparison-of-agents-that-affect-aldosterone-action
#36
REVIEW
Juan Tamargo, Anna Solini, Luis M Ruilope
The first aldosterone blocker, spironolactone, initially was used as a diuretic but was accompanied by a significant amount of side effects that necessitated the withdrawal of the drug in a relevant number of patients. The discovery of the many receptor-mediated actions of aldosterone in several different organs greatly contributed to expand the indications of aldosterone blockers. Eplerenone was the second component of this class of drugs and differed from spironolactone because of its significantly better safety, albeit this was accompanied by a lower potency when used at equinumeric doses...
May 2014: Seminars in Nephrology
https://read.qxmd.com/read/25119614/low-sodium-intake-cardiovascular-health-benefit-or-risk
#37
EDITORIAL
Suzanne Oparil
No abstract text is available yet for this article.
August 14, 2014: New England Journal of Medicine
https://read.qxmd.com/read/25140012/the-evolution-of-blood-pressure-and-the-rise-of-mankind
#38
REVIEW
Kevin Schulte, Uta Kunter, Marcus J Moeller
Why is it that only human beings continuously perform acts of heroism? Looking back at our evolutionary history can offer us some potentially useful insight. This review highlights some of the major steps in our evolution-more specifically, the evolution of high blood pressure. When we were fish, the first kidney was developed to create a standardized internal 'milieu' preserving the primordial sea within us. When we conquered land as amphibians, the evolution of the lung required a low systemic blood pressure, which explains why early land vertebrates (amphibians, reptiles) are such low performers...
May 2015: Nephrology, Dialysis, Transplantation
https://read.qxmd.com/read/24893089/resistant-hypertension-a-review-of-diagnosis-and-management
#39
REVIEW
Wanpen Vongpatanasin
Resistant hypertension-uncontrolled hypertension with 3 or more antihypertensive agents-is increasingly common in clinical practice. Clinicians should exclude pseudoresistant hypertension, which results from nonadherence to medications or from elevated blood pressure related to the white coat syndrome. In patients with truly resistant hypertension, thiazide diuretics, particularly chlorthalidone, should be considered as one of the initial agents. The other 2 agents should include calcium channel blockers and angiotensin-converting enzyme inhibitors for cardiovascular protection...
June 4, 2014: JAMA
https://read.qxmd.com/read/24815771/what-is-the-optimal-treatment-for-patients-with-atherosclerotic-renal-artery-stenosis
#40
COMMENT
Barbara A Greco, Benjamin J Freda
No abstract text is available yet for this article.
August 2014: American Journal of Kidney Diseases
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