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Hypertension and diuretic

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https://www.readbyqxmd.com/read/29348380/effect-of-nigella-sativa-seed-extract-for-hypertension-in-elderly-a-double-blind-randomized-controlled-trial
#1
Aulia Rizka, Siti Setiati, Aida Lydia, Esthika Dewiasty
BACKGROUND: Nigella sativa (NS) seed extract shows diuretic activity, inhibits sympathetic nervous system overactivity and increases the production of Nitric Oxide in in vivo studies, thus it has a potential use as an adjuvant antihypertensive for elderly population. This study aimed to determine the effect of Nigella sativa seed extract to systolic blood pressure (SBP) and diastolic blood pressure (DBP) of elderly patients with hypertension. METHODS: a double-blind, randomized controlled trial was conducted on elderly subjects with hypertension in three outpatient clinics in Cipto Mangunkusumo National Hospital Jakarta Indonesia from June to September 2011...
October 2017: Acta Medica Indonesiana
https://www.readbyqxmd.com/read/29346252/sarcoidosis-with-pleural-effusion-as-the-presenting-symptom
#2
Estefania Rivera, Yaron Gesthalter, Paul Vardelaan, Alex Chee, Adnan Majid
A 65-year-old woman, never smoker, with medical history of hypertension, nonischemic cardiomyopathy, and moderate pulmonary hypertension presented with symptomatic bilateral pleural effusions. Thoracentesis revealed a lymphocyte predominant transudate and was negative for malignancy, microbiologic cultures were negative for an infectious cause. Chest tomography showed mediastinal and bilateral hilar lymphadenopathy, lymph node biopsy with endobronchial ultrasound-guided transbronchial needle aspiration showed non-necrotizing granulomas compatible with sarcoidosis...
January 16, 2018: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/29339688/choice-of-treatment-based-on-turkish-hypertension-consensus-report-do-we-follow-the-recommendations
#3
Gülden Yürüyen, İlkim Deniz Toprak, Zeki Toprak, Murat Akarsu, Pınar Demir, Yücel Arman, Eylem Özgün Çil, Mustafa Özcan, Sedat Irmak, Özgür Altun, Şengül Aydın Yoldemir, Hasan Eruzun, Tufan Tükek
OBJECTIVE: The aim of this study was to determine how often the recommendations of the Turkish Hypertension Consensus Report are followed, and to draw attention to the report. METHODS: The demographic information of 1000 patients diagnosed with hypertension and the details of the antihypertensive medications prescribed at the outpatient service of a tertiary care hospital were recorded, and the data were compared with the recommendations of the report. RESULTS: The mean age of the patients was 62±11 years...
January 2018: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/29331339/cardiopulmonary-hemodynamics-and-c-reactive-protein-as-prognostic-indicators-in-compensated-and-decompensated-cirrhosis
#4
Laura Turco, Guadalupe Garcia-Tsao, Ilenia Magnani, Marcello Bianchini, Martina Costetti, Cristian Caporali, Stefano Colopi, Emilio Simonini, Nicola De Maria, Federico Banchelli, Rosario Rossi, Erica Villa, Filippo Schepis
BACKGROUND AND AIMS: The main stages of cirrhosis (compensated and decompensated) have been substaged based on clinical, endoscopic, and portal pressure (determined by the hepatic venous pressure gradient, HVPG) features. Vasodilatation leading to a hyperdynamic circulatory state is central in the development of a late decompensated stage with inflammation being currently considered a key driver. We aimed to assess hepatic/systemic hemodynamics and inflammation (by C reactive protein, CRP) among the different substages of cirrhosis and to investigate their interrelationship and prognostic relevance...
January 10, 2018: Journal of Hepatology
https://www.readbyqxmd.com/read/29321043/what-is-in-your-wallet-a-cluster-randomized-trial-of-the-effects-of-showing-comparative-patient-out-of-pocket-costs-on-primary-care-prescribing-for-uncomplicated-hypertension
#5
Robyn Tamblyn, Nancy Winslade, Christina J Qian, Teresa Moraga, Allen Huang
BACKGROUND: Drug expenditures are responsible for an increasing proportion of health costs, accounting for $1.1 trillion in annual expenditure worldwide. As hundreds of billions of dollars are being spent each year on overtreatment with prescribed medications that are either unnecessary or are in excess of lowest cost-effective therapy, programs are needed that optimize fiscally appropriate use. We evaluated whether providing physicians with information on the patient out-of-pocket payment consequences of prescribing decisions that were in excess of lowest cost-effective therapy would alter prescribing decisions using the treatment of uncomplicated hypertension as an exemplar...
January 10, 2018: Implementation Science: IS
https://www.readbyqxmd.com/read/29316186/organ-damage-changes-in-patients-with-resistant-hypertension-randomized-to-renal-denervation-or-spironolactone-the-denervhta-denervaci%C3%A3-n-en-hipertensi%C3%A3-n-arterial-study
#6
Anna Oliveras, Pedro Armario, Laia Sans, Albert Clarà, Susana Vázquez, Luis Molina, Júlia Pareja, Alejandro de la Sierra, Julio Pascual
Renal denervation and spironolactone have both been proposed for the treatment of resistant hypertension, but their effects on preclinical target organ damage have not been compared. Twenty-four patients with 24-hour systolic blood pressure ≥140 mm Hg despite receiving three or more full-dose antihypertensive drugs, one a diuretic, were randomized to receive spironolactone or renal denervation. Changes in 24-hour blood pressure, urine albumin excretion, arterial stiffness, carotid intima-media thickness, and left ventricular mass index were evaluated at 6 months...
January 5, 2018: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/29311408/hepatic-hydrothorax
#7
Yong Lv, Guohong Han, Daiming Fan
Hepatic hydrothorax (HH) is a pleural effusion that develops in a patient with cirrhosis and portal hypertension in the absence of cardiopulmonary disease. Although the development of HH remains incompletely understood, the most acceptable explanation is that the pleural effusion is a result of a direct passage of ascitic fluid into the pleural cavity through a defect in the diaphragm due to the raised abdominal pressure and the negative pressure within the pleural space. Patients with HH can be asymptomatic or present with pulmonary symptoms such as shortness of breath, cough, hypoxemia, or respiratory failure associated with large pleural effusions...
December 27, 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/29304216/hypertension-control-in-adults-with-ckd-in-china-baseline-results-from-the-chinese-cohort-study-of-chronic-kidney-disease-c-stride
#8
Zhe Yan, Yu Wang, Shaomei Li, Jinwei Wang, Luxia Zhang, Huibin Tan, Sumin Li, Lin Yang, Huaying Pei, Liping Zhang, Yan Wang, Jianzhao Duan, Sumin Jiao, Minghui Zhao, Shuxia Fu
Background: Hypertension contributes to increased morbidity and mortality in the chronic kidney disease (CKD) population. Studies on blood pressure control in CKD patients in China are limited. In this study, we aimed to describe the status of blood pressure control in Chinese CKD patients based on the first national prospective CKD cohort data. Methods: A subgroup of Chinese Cohort Study of Chronic Kidney Disease (C-STRIDE) participants with hypertension at baseline was included in the present study...
January 3, 2018: American Journal of Hypertension
https://www.readbyqxmd.com/read/29303829/sex-differences-in-antihypertensive-treatment-in-france-among-17%C3%A2-856-patients-in-a-tertiary-hypertension-unit
#9
Thérèse Deborde, Laurence Amar, Guillaume Bobrie, Nicolas Postel-Vinay, Christiane Battaglia, Amokrane Tache, Antoine Chedid, Mohamed-Malek Dhib, Gilles Chatellier, Pierre-François Plouin, Anita Burgun, Michel Azizi, Anne-Sophie Jannot
BACKGROUND: Sex differences in antihypertensive treatment have often been highlighted, but whether there is truly a difference or whether this difference is mediated by confounding factors has yet to be deciphered. PATIENTS AND METHODS: We performed a cross-sectional study on the first consultation in the Georges Pompidou Hospital Tertiary Hypertension Unit between July 2000 and June 2015 to explore sex differences in both patient and treatment characteristics over this period...
January 4, 2018: Journal of Hypertension
https://www.readbyqxmd.com/read/29301757/prior-medications-and-the-cardiovascular-benefits-from-combination-angiotensin-converting-enzyme-inhibition-plus-calcium-channel-blockade-among-high-risk-hypertensive-patients
#10
Robert D Brook, Niko Kaciroti, George Bakris, Björn Dahlöf, Bertram Pitt, Eric Velazquez, Michael Weber, Dion H Zappe, Tsushung Hau, Kenneth A Jamerson
BACKGROUND: The ACCOMPLISH (Avoiding Cardiovascular Events Through Combination Therapy in Patients Living with Systolic Hypertension) trial demonstrated that combination therapy using amlodipine, rather than hydrochlorothiazide, in conjunction with benazepril provided greater cardiovascular risk reduction among high-risk hypertensive patients. Few trials have evaluated the effect of prior antihypertensive therapy used among participants on the study outcomes. METHODS AND RESULTS: In a post hoc observational analysis, we examined the characteristics of the drug regimens taken before trial enrollment in the context of the primary composite outcome (death from cardiovascular causes, nonfatal myocardial infarction, nonfatal stroke, hospitalization for angina, resuscitation after sudden cardiac death, and coronary revascularization)...
January 4, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29287767/resistant-hypertension-renal-denervation-or-intensified-medical-treatment
#11
REVIEW
Alberto Morganti, Giuseppe Mancia
Resistant hypertension (RH) can be diagnosed if blood pressure (BP) is not controlled with the combination of three antihypertensive drugs, including a diuretic, all at effective doses. Patients affected by this condition exhibit a marked increase in the risk of cardiovascular and renal morbid and fatal events. They also exhibit an increased activity of the sympathetic nervous system which is likely to importantly contribute at the renal and other vascular levels to the hypertensive state. Almost 10years ago renal denervation (RDN) by radiofrequency thermal energy delivery to the walls of the renal arteries was proposed for the treatment of RH...
December 27, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/29287584/risk-factors-for-community-acquired-acute-kidney-injury-in-patients-with-and-without-chronic-kidney-injury-and-impact-of-its-initial-management-on-prognosis-a-prospective-observational-study
#12
Fabien Stucker, Belen Ponte, Victoria De la Fuente, Cyrielle Alves, Olivier Rutschmann, Sebastian Carballo, Nicolas Vuilleumier, Pierre-Yves Martin, Thomas Perneger, Patrick Saudan
BACKGROUND: We aimed to describe clinical characteristics of patients with community-acquired acute kidney injury (CA-AKI), the effectiveness of initial management of CA-AKI, its prognosis and the impact of medication on its occurrence in patients with previous chronic kidney injury (CKI). METHODS: We undertook a prospective observational study within the Emergency Department (ED) of a University Hospital, screening for any patient >16 years admitted with an eGFR <60 ml/mn/1...
December 29, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/29276921/-indapamide-sr-amlodipine-fixed-dose-combination-novel-approach-to-effective-control-of-systolic-arterial-pressure
#13
O N Tkachyeva, Y V Kotovskaya, E N Dudinskaya
Effective control of arterial pressure (AP) is achieved only in ⅓ of patients with arterial hypertension. It is especially difficult to achieve control of systolic (S) AP in elderly patients in whom SAP is the strongest prognostic factor of cardiovascular complications. Thiazide and thiazide-like diuretics and calcium antagonists are effective for lowering of elevated SAP and pulse (P) AP including aortic PAP elevation of which is associated with high stiffness of arterial wall and is typical for elderly people...
November 2017: Kardiologiia
https://www.readbyqxmd.com/read/29275380/double-hit-a-unique-case-of-resistant-hypertension
#14
Kristen Elizabeth DeCarlo, Nidhi Agrawal
A middle-aged woman with obesity, hyperlipidaemia and diet-controlled diabetes was referred for resistant hypertension. Her blood pressure (BP) was uncontrolled on five medications, including a diuretic. Physical exam revealed a systolic ejection murmur, and ECHO demonstrated moderate hypertrophy. Laboratory examination revealed elevated aldosterone level (20.7 ng/dL) and elevated aldosterone:renin ratio (41.4 (ng/dL)/(ng/mL/h)), meeting criteria for primary aldosteronism (PA), and confirmed by saline infusion testing...
December 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29251761/single-pill-combinations-spcs-and-treatment-of-arterial-hypertension-in-poland-expert-consensus-statement-of-the-polish-society-of-hypertension-and-polish-cardiac-society-working-group-on-cardiovascular-pharmacotherapy
#15
Andrzej Tykarski, Krystyna Widecka, Krzysztof Narkiewicz, Beata Wożakowska-Kapłon, Zbigniew Gaciong, Stefan Grajek, Tomasz Grodzicki, Andrzej Januszewicz, Jacek Wolf, Aleksander Prejbisz, Katarzyna Kostka-Jeziorny, Krzysztof J Filipiak
The reasons for the publication of current expert consensus statement after 4 years from the previous one are: the growing number of evidence on the benefits of the use of single-pill combinations (SPCs) in hypertension (also with concomitant dyslipidaemia), the extension of indications for their use in the hypertension management algorithm and the emergence in recent years after the publication of Polish Society of Hypertension experts' position statement in 2013 of new types of SPCs available to doctors in Poland, including triple-drug combinations of antihypertensives and the so-called "hybrids" SPCs containing not only antihypertensive drugs but also statins...
2017: Kardiologia Polska
https://www.readbyqxmd.com/read/29247499/cardiac-output-changes-after-osmotic-therapy-in-neurosurgical-and-neurocritical-care-patients-a-systematic-review-of-the-clinical-literature
#16
Georgia Tsaousi, Elisabetta Stazi, Marco Cinicola, Federico Bilotta
AIM: Osmotherapy constitutes a first-line intervention for intracranial hypertension management. However, hyperosmolar solutes exert various systematic effects, among which their impact on systemic hemodynamics is poorly clarified. This review aims to appraise the clinical evidence of the effect of mannitol and hypertonic saline (HTS) on cardiac performance in neurosurgical and neurocritical care patients. METHOD: A database search was conducted to identify randomized clinical trials and observational studies reporting HTS or mannitol use in acute brain injury setting...
December 16, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29235365/a-phase-iii-open-label-multicenter-study-to-evaluate-the-safety-and-efficacy-of-long-term-triple-combination-therapy-with-azilsartan-amlodipine-and-hydrochlorothiazide-in-patients-with-essential-hypertension
#17
Hiromi Rakugi, Kohei Shimizu, Yuya Nishiyama, Yuhei Sano, Yuusuke Umeda
PURPOSE: Patients with essential hypertension who are receiving treatment with an angiotensin II receptor blocker and a calcium channel blocker often develop inadequate blood pressure (BP) control and require the addition of a diuretic. This study aimed to evaluate the long-term safety and efficacy of a triple combination therapy with 20 mg azilsartan (AZL), 5 mg amlodipine (AML) and 12.5 mg hydrochlorothiazide (HCTZ). MATERIALS AND METHODS: The phase III, open-label, multicenter study (NCT02277691) comprised a 4-week run-in period and 52-week treatment period...
December 13, 2017: Blood Pressure
https://www.readbyqxmd.com/read/29234523/amlodipine-vs-hydrochlorothiazide-is-there-any-disparity-in-its-antihypertensive-effect-or-not
#18
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
https://www.readbyqxmd.com/read/29234376/roles-of-nitric-oxide-and-prostaglandins-in-the-sustained-antihypertensive-effects-of-acanthospermum-hispidum-dc-on-ovariectomized-rats-with-renovascular-hypertension
#19
Rhanany Alan Calloi Palozi, Maysa Isernhagen Schaedler, Cleide Adriane Signor Tirloni, Aniely Oliveira Silva, Francislaine Aparecida Dos Reis Lívero, Roosevelt Isaias Carvalho Souza, Ariany Carvalho Dos Santos, Thiago Bruno Lima Prando, Lauro Mera de Souza, Arquimedes Gasparotto Junior
Although Acanthospermum hispidum is used in Brazilian folk medicine as an antihypertensive, no study evaluated its effects on a renovascular hypertension and ovariectomy model. So, this study investigated the mechanisms involved in the antihypertensive effects of an ethanol-soluble fraction obtained from A. hispidum (ESAH) using two-kidney-one-clip hypertension in ovariectomized rats (2K1C plus OVT). ESAH was orally administered at doses of 30, 100, and 300 mg/kg, daily, for 28 days, after 5 weeks of surgery...
2017: Evidence-based Complementary and Alternative Medicine: ECAM
https://www.readbyqxmd.com/read/29227377/effectiveness-of-low-dose-diuretics-for-blood-pressure-reduction-to-optimal-values-in-prehypertension-a-randomized-clinical-trial
#20
Flávio D Fuchs, Sandra C Fuchs, Carlos E Poli-de-Figueiredo, José A Figueiredo Neto, Luiz César N Scala, José F Vilela-Martin, Leila B Moreira, Hilton Chaves, Marco Mota Gomes, Marcos R de Sousa, Ricardo Pereira E Silva, Iran Castro, Evandro José Cesarino, Ana Luiza Lima Sousa, João Guilherme Alves, André Avelino Steffens, Andréa Araujo Brandão, Luiz Aparecido Bortolotto, Abrahão Afiune Neto, Antônio C Nóbrega, Roberto Silva Franco, Dario C Sobral Filho, Fernando Nobre, Rosane Schlatter, Miguel Gus, Caroline Nespolo De David, Leticia Rafaelli, Guilhermo Prates Sesin, Otávio Berwanger, Paul K Whelton
BACKGROUND: To determine the effectiveness of low-dose diuretic therapy to achieve an optimal level of blood pressure (BP) in adults with prehypertension. METHODS: The PREVER-prevention trial was a randomized, parallel, double-blinded, placebo-controlled trial, with 18 months of follow-up, conducted at 21 academic medical centers in Brazil. Of 1772 individuals evaluated for eligibility, 730 volunteers with prehypertension who were aged 30-70 years, and who did not reach optimal blood pressure after 3 months of lifestyle intervention, were randomized to a fixed association of chlorthalidone 12...
December 7, 2017: Journal of Hypertension
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