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Clinical Hypertension

Ravi Tejraj Mehta, Anil Pareek, Indranil Purkait
We have read the study design "Comparison of effects between calcium channel blocker and diuretics in combination with angiotensin II receptor blocker on 24-h central blood pressure and vascular hemodynamic parameters in hypertensive patients: study design for a multicenter, double-blinded, active controlled, phase 4, randomized trial" by Oh GC, et al. with interest. The authors aim to compare the efficacy of amlodipine or hydrochlorothiazide (HCTZ) with an ARB. However, we wish to highlight that chlorthalidone (CTD) is the evidence-based and recommended anti-hypertensive diuretic, and should replace HCTZ in the trial to effectively compare efficacy against the CCB amlodipine...
2018: Clinical Hypertension
Lawrence A Olatunji, Olatunde P Olabode, Olawale M Akinlade, Abiola S Babatunde, Victoria A Olatunji, Ayodele O Soladoye
Background: A seemingly interesting observation in patients with sickle cell anaemia (SCA) is that they usually have lower systemic blood pressures (BP) and insulin resistance than persons in the general population in spite of chronic inflammation and vasculopathy. However, relative systemic hypertension (rHTN) has been linked to pulmonary hypertension, increased blood viscosity and renal insufficiency, which could indicate a risk of developing cardiometabolic disorder (CMD) in SCA.We therefore hypothesized that neck circumference (NC) and CMD marker; triglyceride glucose (TyG) index would independently predict rHTN in young adults with SCA in steady state...
2018: Clinical Hypertension
Attila Juhasz, Jingtao Wu, Michie Hisada, Tomoka Tsukada, Myung Ho Jeong
Background: This was a phase 3, randomized, double-blind, placebo-controlled study. Methods: Adult Korean patients with essential hypertension and a baseline mean sitting clinic systolic blood pressure (scSBP) ≥150 and ≤180 mmHg were randomized to 6-week treatment with placebo ( n = 65), azilsartan medoxomil (AZL-M) 40 mg ( n = 132), or AZL-M 80 mg ( n = 131). The primary endpoint was the change from baseline to week 6 in trough scSBP. Results: The least-squares mean (standard error) change from baseline in trough scSBP in the placebo, AZL-M 40-mg, and 80-mg groups at week 6 were - 8...
2018: Clinical Hypertension
Ryuichi Kawamoto, Daisuke Ninomiya, Kensuke Senzaki, Teru Kumagi
Background: Few data is available on the association between body mass index (BMI), serum uric acid (SUA) levels and blood pressure (BP) categories in the disease continuum, when efforts for its prevention may be applicable. Methods: We performed a cross-sectional study to examine the association between BMI, SUA and BP in a community-dwelling sample of Japanese men. Individuals not on antihypertensive and uric acid lowering medications, and aged 50 to 90 years [817men aged 66 ± 9 (mean ± standard deviation) years] were recruited for the survey during a community based annual medical check-up...
2018: Clinical Hypertension
Sintayehu Muleta, Tsegaye Melaku, Legese Chelkeba, Desta Assefa
Background: Hypertension is the major contributor to cardiovascular diseases related morbidity and mortality. Blood pressure is not well controlled in the majority of patients with both diabetes and hypertension. The main objective of this study was to assess blood pressure control and its determinants among diabetes mellitus co- morbid hypertensive ambulatory patients. Methods: Hospital based cross sectional study was conducted among diabetes mellitus co-morbid hypertensive ambulatory adult patients based on the inclusion criteria...
2017: Clinical Hypertension
Rodrigo Nazário Leão, Pedro Marques Silva, Luísa Branco, Helena Fonseca, Bruno Bento, Marta Alves, Daniel Virella, Roberto Palma Reis
Background: The use of impedance cardiography (ICG) may play a role in the assessment of cardiac effects of hypertension (HT), especially its hemodynamic features. Hypertensive heart disease involves structural changes and alterations in left ventricular geometry that end up causing systolic and/or diastolic dysfunction. The IMPEDDANS study aims to assess the usefulness of ICG for the screening of left ventricular diastolic dysfunction (LVDD) in patients with HT. Methods: Patients with HT were assessed by echocardiography and ICG...
2017: Clinical Hypertension
Hyunsu Kim, Sang-Hoon Cho, Kyoung-Im Cho, Bong-Joon Kim, Sung-Il Im, Jung-Ho Heo
Background: Autonomic nervous system activity has been shown to be altered in patients with vasospastic angina (VA). Heart rate recovery (HRR) is a simple, non-invasive measurement of autonomic nervous system dysfunction. We aimed to investigate whether HRR is related to VA, as established by an ergonovine test. Methods: A total of 976 consecutive patients (47.5% male, mean age 55 years) without significant coronary artery disease who underwent both an ergonovine provocation test and a treadmill exercise test were enrolled...
2017: Clinical Hypertension
Venu Gopal Jonnalagadda, Kanchan Choudhary, Vijay Kranti Matety
We have read the article "Comparison of effects between calcium channel blocker and diuretics in combination with angiotensin II receptor blocker on 24-h central blood pressure and vascular hemodynamic parameters in hypertensive patients: study design for a multicenter, double-blinded, active controlled, phase 4, randomized trial" by GC Oh., et al. and found it quite interesting to learn the testing of effectiveness between amlodipine and hydrochlorothiazide in combination with losartan. After 4 weeks of therapy, non-responders were exposed for dose titration of losartan/amlodipine 100/5 mg daily or losartan/hydrochlorothiazide 100/25 mg daily...
2017: Clinical Hypertension
Seung Won Lee, Hae-Young Lee, Sang Hyun Ihm, Sung Ha Park, Tae Hyun Kim, Hyeon Chang Kim
Background: The purpose of this survey was to evaluate the performance of hypertension screening in medical institutions conducting the national general health screening program of the Republic of Korea. Methods: We contacted 700 medical institutions of Seoul and Incheon areas which performed the national general health screening program in 2016, and 210 of them completed telephone survey. The questions asked in the survey include equipment, environment, personnel and quality control procedures for blood pressure (BP) measurement, and interpretation of the measurements...
2017: Clinical Hypertension
Eyasu Siyum Buda, Lolemo Kelbiso Hanfore, Robera Olana Fite, Alula Seyum Buda
Background: Hypertension is one of the leading causes of disability and death in both developed and developing countries that need urgent strategies to implement interventions that control it. Appropriate lifestyle changes often called non-pharmacological approaches that often overlooked are the corner stone of the prevention and control of hypertension. The aim of this study is to assess the practice of lifestyle modifications and associated factors among diagnosed hypertensive patients in Durame and Nigist Elleni Mohamed Memorial General Hospitals in southern Ethiopia...
2017: Clinical Hypertension
Satish Maharaj, Karan Seegobin, Julio Perez-Downes, Belinda Bajric, Simone Chang, Pramod Reddy
Background: Carvedilol is used in the management of hypertension, ischemic heart disease, heart failure and most recently, portal hypertension. It has been associated with improved outcomes regarding variceal bleeding, hepatic decompensation and death when compared to propranolol and endoscopic band ligation. The main cause of portal hypertension is cirrhosis and therefore carvedilol is increasingly used in these patients. Due to its extensive hepatic metabolism, carvedilol is contraindicated in severe hepatic impairment...
2017: Clinical Hypertension
Chang-Yeon Kim, Mi-Kyung Ye, Young Soo Lee
Background: The salt-taste threshold can influence the salt appetite, and is thought to be another marker of sodium intake. Many studies have mentioned the relationship between the sodium intake and blood pressure (BP). The aim of this study was to evaluate the relationship between the salt-taste threshold and urinary sodium excretion in normotensive and hypertensive groups. Methods: We analyzed 199 patients (mean age 52 years, male 47.3%) who underwent 24-h ambulatory BP monitoring (ABPM)...
2017: Clinical Hypertension
Darae Kim, Chi Young Shim, Geu-Ru Hong, Sungha Park, InJeong Cho, Hyuk-Jae Chang, Jong-Won Ha, Namsik Chung
Background: Arterial stiffness increases pressure load to the left ventricle (LV), leading to LV hypertrophy and subendocardial ischemia. Neurohormones stimulate myocardial fibrosis and LV dysfunction. We aimed to explore the associations of arterial stiffness and plasma aldosterone with multi-directional, layer-specific LV, and left atrial (LA) mechanical function in hypertensive patients. Methods: Layer-specific LV global longitudinal strain (GLS-trans, GLS-endo, GLS-epi), global circumferential strain (GCS-trans, GCS-endo, GCS-epi), LV torsional parameters, and LA global longitudinal strain (LA GLS) were analyzed by two-dimensional speckle tracking echocardiography in 195 hypertensive patients (110 men, mean age 55 years)...
2017: Clinical Hypertension
Ilse M Schrover, Jannick A N Dorresteijn, Jodine E Smits, A H Jan Danser, Frank L J Visseren, Wilko Spiering
BACKGROUND: In patients with obesity-related hypertension (ORH), reaction to antihypertensive medication is likely influenced by patientcharacteristics. METHODS: Effects of aliskiren, moxonidine and hydrochlorothiazide on 24-h blood pressure (BP) were compared to placebo. Linear mixed effect models were used to analyze the effect of patient characteristics on BP levels and treatment response. RESULTS: Systolic BP response to aliskiren was higher in patients with a BMI > 30...
2017: Clinical Hypertension
Takashi Hitsumoto
BACKGROUND: Recent studies have reported the importance of high-sensitivity troponin T (hs-cTnT) or skin autofluorescence (AF) as a cardiovascular risk factor. However, little is known about the relationship between these two markers. The aim of this study was to clarify the clinical impact of skin AF on hs-cTnT in hypertensive patients, from the perspective of primary prevention of cardiovascular events. METHODS: In total, 457 outpatients on treatment for hypertension [182 men and 275 women; mean (± SD) age, 67 ± 13 y] and with no history of cardiovascular events were enrolled...
2017: Clinical Hypertension
Gyu Chul Oh, Hae-Young Lee, Wook Jin Chung, Ho-Joong Youn, Eun-Joo Cho, Ki-Chul Sung, Shung Chull Chae, Byung-Su Yoo, Chang Gyu Park, Soon Jun Hong, Young Kwon Kim, Taek-Jong Hong, Dong-Ju Choi, Min Su Hyun, Jong Won Ha, Young Jo Kim, Youngkeun Ahn, Myeong Chan Cho, Soon-Gil Kim, Jinho Shin, Sungha Park, Il-Suk Sohn, Chong-Jin Kim
BACKGROUND: Hypertension is a risk factor for coronary heart disease and stroke, and is one of the leading causes of death. Although over a billion people are affected worldwide, only half of them receive adequate treatment. Current guidelines on antihypertensive treatment recommend combination therapy for patients not responding to monotherapy, but as the number of pills increase, patient compliance tends to decrease. As a result, fixed-dose combination drugs with different antihypertensive agents have been developed and widely used in recent years...
2017: Clinical Hypertension
Brycen Ratcliffe, Robert Pawlak, Francisco Morales, Caleb Harrison, Alvaro N Gurovich
BACKGROUND: Flow Mediated Dilation (FMD) has immense potential to become a clinical, non-invasive biomarker of endothelial function and nitric oxide bioavailability, which regulate vasomotor activity. Unfortunately, FMD analysis techniques could deviate significantly in different laboratories if a validation process is not involved. The purpose of this study was to provide validation to the assessment of FMD analysis in our laboratory and to standardize this process before reporting results of FMD...
2017: Clinical Hypertension
Suk-Won Choi, Seong Woo Han, Jong Sun Ok, Byung-Su Yoo, Mi-Seung Shin, Sung Ha Park, Kyu-Hyung Ryu
BACKGROUND: The Korean Registry of Target Organ Damage in Hypertension aims to evaluate the clinical characteristics and prevalence of subclinical target organ damage in Korean hypertensive patients. METHOD: This is a prospective, observational, multicenter cohort study in which 23 university hospitals participated. Since May 2013, we have enrolled 1,318 consecutive hypertensive patients without known cardiovascular disease who met the following inclusion criteria: 1) age older than 30 years and 2) the first visit to the participating hospitals was within the last 5 years...
2017: Clinical Hypertension
Natalia Herakova, Nnenna Harmony Nzeribe Nwobodo, Ying Wang, Fei Chen, Dingchang Zheng
BACKGROUND: It has been reported that deep breathing could reduce blood pressures (BP) in general. It is also known that BP is decreased during inhalation and increased during exhalation. Therefore, the measured BPs could be potentially different during deep breathing with different lengths of inhalation and exhalation. This study aimed to quantitatively investigate the effect of different respiratory patterns on BPs. METHODS: Forty healthy subjects (20 males and 20 females, aged from 18 to 60 years) were recruited...
2017: Clinical Hypertension
Pamela Nyaradzai Magande, Daniel Chirundu, Notion Tafara Gombe, More Mungati, Mufuta Tshimanga
BACKGROUND: Clients on anti-retroviral therapy (ART) are living longer and have risk of hypertension. Side effects of medicines and aging increase this risk. Hypertension prevalence among clients on ART in Kadoma City was estimated to be 30% in 2015. Of these, 61% had uncontrolled hypertension. This was high compared to 46% of hypertensives in the general population who had uncontrolled hypertension. We determined factors associated with uncontrolled hypertension among clients on ART...
2017: Clinical Hypertension
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