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Hypertension and diuretic

Andrew Jeyaruban, Muriel Soden, Sarah Larkins
To examine the management of gout in general practice in Townsville, Australia, and to explore comorbid conditions in patients with gout. Study will also explore how closely guidelines are being followed in managing gout. Retrospective chart review was conducted from May to November 2014 in three general practices in Townsville. Registers for patients were established by searching "gout" and "gouty arthritis". Three hundred and twenty-one patients were included in the study after excluding inactive patients, patients below age of 18 and patients with cancer...
October 21, 2016: Rheumatology International
Ricardo Rodrigues Figueiredo, Andréia Aparecida Azevedo, Norma De Oliveira Penido
INTRODUCTION: Tinnitus is the perception of noise in the absence of an external source and is considered by most authors as a multifactorial symptom. A systematic review concerning the association of tinnitus and systemic arterial hypertension retrieved suggestions of a positive association, but the articles included failed to perform a detailed analysis on the theme. PURPOSE: To analyze the presence of arterial hypertension in tinnitus and non-tinnitus patients, to analyze differences between tinnitus impact and psychoacoustic measurements in hypertensive and normotensive patients, and to evaluate the association between the presence of tinnitus and the diverse antihypertensive drugs employed...
2016: Frontiers in Neurology
Ana Rosa Cunha, Jenifer D'El-Rei, Fernanda Medeiros, Bianca Umbelino, Wille Oigman, Rhian M Touyz, Mario F Neves
BACKGROUND: Epidemiological studies demonstrate an inverse association between serum magnesium and incidence of cardiovascular disease. Diuretics commonly cause hypomagneseamia. METHOD: We evaluated effects of magnesium supplementation on blood pressure (BP) and vascular function in thiazide-treated hypertensive women in a randomized, double-blind, clinical trial. Hypertensive women (40-65 years) on hydrochlorothiazide and mean 24-h BP at least 130/80 mmHg were divided into placebo and supplementation (magnesium chelate 600 mg/day) groups...
October 18, 2016: Journal of Hypertension
Rajkumar Bharatia, Manoj Chitale, Ganesh Narain Saxena, Raman Ganesh Kumar, Chikkalingaiah, Abhijit Trailokya, Kalpesh Dalvi, Suhas Talele
INTRODUCTION: Hypertension (HTN), being a major risk factor for cardiovascular diseases (CVDs), is an important issue of medical and public health. High blood pressure (BP) is ranked as the third most important risk factor for attributable burden of disease in south Asia (2010). Hypertension (HTN) exerts a substantial public health burden on cardiovascular health status and healthcare systems in India. Uncontrolled hypertension among adults with hypertension is associated with increased mortality...
July 2016: Journal of the Association of Physicians of India
Francislaine Aparecida Lívero, Jacqueline Vergutz Menetrier, Emerson Luiz Botelho Lourenço, Arquimedes Gasparotto Junior
Heart failure, hypertension, cirrhosis and nephritic syndrome are among conditions that alter volume and composition of body fluids and are modulated by diuretics. Natural products are important source of diuretics and have been considered remarkable alternative with greater effectiveness and fewer side effects. However, many of these plants used in traditional medicine must be scientifically assessed about their efficacy and toxicity. Despite the large number of published articles claiming that plants or plant-derived components may act as diuretic agents, few studies have addressed the mechanism of action of medicinal plants...
October 14, 2016: Current Pharmaceutical Design
Almotasembellah Aljaafareh, Jose Ruben Valle, Yu-Li Lin, Yong-Fang Kuo, Gulshan Sharma
OBJECTIVES: Long-acting bronchodilators are mainstay treatment for moderate to severe chronic obstructive pulmonary disease. A growing body of evidence indicates an increased risk of cardiovascular events upon initiation of these medications. We hypothesize that this risk is higher in patients with chronic obstructive pulmonary disease who had a preexisting cardiovascular disease regardless of receipt of any cardiovascular medication. METHODS: A retrospective cohort of patients with a diagnosis of chronic obstructive pulmonary disease based on two outpatient visits or one inpatient visit for chronic obstructive pulmonary disease (International Classification of Diseases, 9th Edition, Clinical Modification codes 491...
2016: SAGE Open Medicine
Matthew L Maciejewski, Xiaojuan Mi, Lesley H Curtis, Judy Ng, Samuel C Haffer, Bradley G Hammill
BACKGROUND: Despite the persistence of significant disparities, few evaluations examine disparities in laboratory testing by race/ethnicity, age, sex, Medicaid eligibility, and number of chronic conditions for Medicare fee-for-service beneficiaries' newly prescribed medications. In Medicare beneficiaries initiating diuretics or digoxin, this study examined disparities in guideline-appropriate baseline laboratory testing and abnormal laboratory values. METHODS AND RESULTS: To evaluate guideline-concordant testing for serum creatinine and serum potassium within 180 days before or 14 days after the index prescription fill date, we constructed retrospective cohorts from 10 states of 99 711 beneficiaries who had heart failure or hypertension initiating diuretic in 2011 and 8683 beneficiaries who had heart failure or atrial fibrillation initiating digoxin...
October 18, 2016: Circulation. Cardiovascular Quality and Outcomes
Michael G Ziegler, Milos Milic
PURPOSE OF REVIEW: The sympathetic nervous system (SNS) mediates short-term increases in blood pressure. Evidence that psychosocial stress leads to chronic hypertension is mixed. The SNS activation found in obstructive sleep apnea (OSA), caregiving for a severely demented spouse, and obesity more specifically address whether SNS activation might lead to the metabolic syndrome and hypertension. RECENT FINDINGS: Obesity is associated with both increased SNS electrical activity and plasma norepinephrine...
October 15, 2016: Current Opinion in Nephrology and Hypertension
Eun Joo Cho, Hae Young Lee, Ki Chul Sung, Sungha Park, Chang Gyu Park, Dong-Ju Choi, Jong Won Ha, Young Keun Ahn, Jinho Shin, Soon-Jun Hong, Soon Kil Kim, Wook-Jin Chung, Byung Su Yoo, Taek Jong Hong, Ho Joong Youn, Myeong-Chan Cho, Shung Chull Chae, Young Jo Kim, Chong-Jin Kim
BACKGROUND: The aim of this study was to compare 24-hour central blood pressure (24 hr c-BP) reduction efficacy between angiotensin II receptor blocker (ARB) combined with calcium channel blocker and with diuretics. METHODS: We conducted a prospective, randomized, double-blind trial in 220 hypertensive patients [mean age = 59.6 ± 12.3 years, men = 154(70%)]. Patients received losartan 50 mg monotherapy for 4 weeks, followed by additional use of amlodipine 5 mg (L/A group) or hydrochlorothiazide 12...
September 2016: Journal of Hypertension
Zhiming Zhu
Management of hypertension in diabetes is critical for reducing cardiovascular mortality and morbidity. Dietary approaches for controlling high blood pressure have historically focused on sodium. Thus, many guidelines recommend that patients with type 2 diabetes reduce high sodium intake. Nonetheless, the potential benefits of sodium reduction are debatable. The kidney has a crucial role in glucose filtration and reabsorption in addition to its regulation of fluid and electrolyte homeostasis. A key factor linking sodium uptake and glucose transport is the sodium-glucose cotransporter 2 (SGLT2) in renal proximal tubular cells...
September 2016: Journal of Hypertension
Seong Hwan Kim
Resistant hypertension is defined as blood pressure that remains above 140/90 mmHg in spite of the concurrent use of three antihypertensive agents of different classes at optimal dosing, of which one should be a diuretic. Accordingly, it is not synonymous with uncontrolled hypertension. Among a variety of risk factors, obstructive sleep apnea (OSA), which is a common type of sleep-disordered breathing, has been recognized a well-established risk factor for resistant hypertension. Indeed, both European and American guidelines for the management of arterial hypertension stated that OSA is a modifiable cause of resistant hypertension...
September 2016: Journal of Hypertension
Chan Joo Lee, Jaewon Oh, Sang-Hak Lee, Seok-Min Kang, Donghoon Choi, Hyeon-Chang Kim, Sungha Park
OBJECTIVE: In most cases, the 5 first line drugs are recommended for management of hypertension without preference for one or the other. However, it is unclear whether different classes of anti-hypertensive agents have different effect on survival in low risk, uncomplicated hypertension. The aim of this study was to evaluate effects of 4 classes of first line anti-hypertensive agents on improving survival in patients with low risk, uncomplicated hypertension. DESIGN AND METHOD: Adult hypertensive patients without chronic kidney disease, end stage renal disease, diabetes mellitus, acute coronary syndrome, and heart failure in 2002 were selected from Korean National Health Insurance sample cohort consisting of one million subjects...
September 2016: Journal of Hypertension
Zhanna Kobalava
The burden of cardiovascular diseases (CVD) in general and heart failure (HF) in particular continues to increase worldwide. CVD are major contributors to death and morbidity and recognized as important drivers of healthcare expenditure. Chronic overactivity of the renin-angiotensin-aldosterone system (RAAS) plays a key role in human hypertension and HF pathophysiology. RAAS is fundamental in the overall regulation of cardiovascular homeostasis through the actions of hormones, which regulate vascular tone, and specifically blood pressure through vasoconstriction and renal sodium and water retention...
September 2016: Journal of Hypertension
David Calhoun
: Resistant hypertension refers to patients with difficult-to-treat hypertension, generally defined as needing three or more medications of different classes, including, if tolerated, a diuretic. Observational studies indicate that the prevalence of resistant hypertension based on the preceding definition of needing 3 or medications for blood pressure (BP) control is approximately 15-20% of patients being treated for hypertension. However, causes of pseudoresistance are common, including poor BP technique, poor adherence, white coat effects, and under-treatment, all of which must be identified in order to distinguish apparent resistance from true treatment resistance...
September 2016: Journal of Hypertension
Suzanne Oparil
Heart disease, stroke, and kidney failure are leading causes of death worldwide, and hypertension is a significant risk factor for each. Hypertension is less common in women, compared to men, in those younger than 45 years of age. This trend is reversed in those 65 years and older. In the US between 2011-2014, the prevalence of hypertension in women and men by age group was 6% vs 8% (18-39 years), 30% vs 35% (40-59 years), and 67% vs 63% (60 years and over). Awareness, treatment, and control rates differ between genders with women being more aware of their diagnosis (85% vs 80%), more likely to take their medications (81% vs 71%) and more frequently having controlled hypertension (55% vs 49%)...
September 2016: Journal of Hypertension
Sverre Kjeldsen
There is a whole armament of good drugs for treatment of hypertension including diuretics, calcium antagonist, angiotensin receptor antagonists and angiotensin converting enzyme inhibitors. Secondary drugs mostly used for special indications include beta-blockers, alpha-blockers, mineralocorticoid receptor antagonists (aldosterone antagonists), renin-inhibitors, centrally acting drugs, direct vasodilators and others.A variety of new drugs targeting different pressor mechanism exist and have partly been studies experimentally but will unlikely make it to clinical use in human hypertension...
September 2016: Journal of Hypertension
Stanislav Pekarskiy, Andrei Baev, Viktor Mordovin, Galina Semke, Tatiana Ripp, Alla Falkovskaya, Ekaterina Sitkova, Valeria Lichikaki, Irina Zubanova, Maria Kuzmichkina, Sergei Popov
OBJECTIVE: A failure of endovascular renal denervation (RDN) as a series of point treatments equally distributed within main trunk of renal artery (Symplicity and other methods) was easily predictable. It may only be effective if all renal nerves closely follow the course of renal artery (RA) from aorta to the kidney. However, surgical studies demonstrated that proximally most renal nerves go at a distance from RA and join mainly its distal part. To evaluate whether denervation treatment in distal part of RA is more effective than conventional RDN...
September 2016: Journal of Hypertension
Alejandro De La Sierra, Julia Pareja, Angela Barrera, Sergi Yun, Pedro Armario, Anna Oliveras
OBJECTIVE: To compare the effect on circadian blood pressure (BP) and BP variability of treatment with sympathetic renal denervation versus spironolactone in resistant hypertensive patients. DESIGN AND METHOD: The DENERVHTA study was a randomized, open trial in 23 resistant hypertensive patients (office systolic BP > 150 and 24-hour systolic BP > 140, while on treatment with at least 3 antihypertensive drugs, one of them a diuretic). Good compliance with antihypertensive medication and eligibility of renal arteries anatomy was ensured before randomization...
September 2016: Journal of Hypertension
Kimika Arakawa, Ai Ibaraki, Yuki Kawamoto, Minako Inoue, Emi Oishi, Mitsuhiro Tominaga, Takuya Tsuchihashi
OBJECTIVE: To investigate the average and variability in urinary salt excretion in treated hypertensive outpatients during several years (median follow-up is 2 years). DESIGN AND METHOD: In our previous research, the subjects were 200 hypertensive patients who underwent at least three measurement of USALT from Sep 2012 to Mar 2013. We extended the follow-up period until Aug 2015 and the subjects were 68 hypertensive patients who were measured USALT 10 times over (65...
September 2016: Journal of Hypertension
Hiroki Uchiwa, Hisashi Kai, Yoshiko Iwamoto, Takahiro Anegawa, Yoshihiro Fukumoto
OBJECTIVE: Morning hypertension is an independent risk for cerebrovascular and cardiovascular events. Although the incidence of morning hypertension increases with age, treatment of morning hypertension has not been established particularly in late-elderly patients. Among various combinations, ARB combined with a small dose of thiazide diuretic is desirable because the two drugs have complementary mechanisms of action, and effectively reduce BP. Thus, we investigated the safety and efficacy of ARB/hydrochlorothiazide (HCTZ) combination in controlling morning hypertension in the very elderly...
September 2016: Journal of Hypertension
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