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https://www.readbyqxmd.com/read/29652421/arterial-hypertension-after-age-65-from-epidemiology-and-pathophysiology-to-therapy-do-we-know-where-we-stand
#1
Jerzy Gąsowski, Karolina Piotrowicz, Franz H Messerli
Arterial hypertension is a prevalent disease with great harming potential. After the age of 55 years the remaining lifetime risk of hypertension amounts to 90%. Despite the constant advances some important issues such as the cut-off blood pressure for the initiation of antihypertensive therapy or the therapeutic goal are debated. In this review, we present - based on the available literature - the current concepts concerning the pathophysiology, epi-demiology and antihypertensive therapy in patients aged 65 years or older...
2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29607790/protective-effects-of-diuretics-against-development-of-cardiovascular-disease-in-patients-with-chronic-kidney-disease-systematic-review
#2
Akinori Aomatsu, Susumu Ookawara, Kenichi Ishibashi, Yoshiyuki Morishita
Cardiovascular disease is one of the most important risk factors for mortality and morbidity in patients with chronic kidney disease (CKD). This systematic review focuses on the protective effects of diuretics against the development of cardiovascular disease in patients with CKD. Among various kinds of diuretics, spironolactone, a mineralocorticoid receptor antagonist, has been shown to have protective effects against cardiovascular disease in patients with all stages of CKD, including pre-dialysis, hemodialysis, and peritoneal dialysis...
April 2, 2018: Cardiovascular & Hematological Agents in Medicinal Chemistry
https://www.readbyqxmd.com/read/29581605/antihypertensive-prescription-pattern-and-compliance-to-jnc-7-and-jnc-8-at-tertiary-care-government-hospital-hyderabad-india-a-cross-sectional-retrospective-study
#3
Varsha Varakantham, Ashok Kumar Kurakula Sailoo, Dinesh Kumar Bharatraj
Background: The monitoring of hypertension treatment can provide insight into the rational drug use pattern. The objective of this study was to examine the antihypertensive medication use among South Indian adults with hypertension in compliance with the hypertension treatment guidelines (Seventh Joint National Committee [JNC 7] and JNC 8). Methods and Results: A total of 550 hypertensive people aged >25 years were included in this retrospective cross-sectional study. The order of drugs prescribed in the year 2012 was beta blockers (BB) > calcium channel blockers (CCB) > CCB + BB > angiotensin receptor blockers (ARB) > angiotensin-converting enzyme inhibitors (ACEI) > thiazide diuretics, whereas in the year 2014, the order has changed drastically, namely, ACEI > CCB > ARB > BB > thiazide diuretics ( P < ...
April 2018: Hospital Pharmacy
https://www.readbyqxmd.com/read/29578856/drug-treatment-of-hypertension-in-older-patients-with-diabetes-mellitus
#4
Srikanth Yandrapalli, Suman Pal, Christopher Nabors, Wilbert S Aronow
Hypertension is more prevalent in the elderly (age>65 years) diabetic population than in the general population and shows an increasing prevalence with advancing age. Both diabetes mellitus (DM) and hypertension are independent risk factors for cardiovascular (CV) related morbidity and mortality. Optimal BP targets were not identified in elderly patients with DM and hypertension. Areas covered: In this review article, the authors briefly discuss the pathophysiology of hypertension in elderly diabetics, present evidence with various antihypertensive drug classes supporting the treatment of hypertension to reduce CV events in older diabetics, and then discuss the optimal target BP goals in these patients...
March 26, 2018: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/29574519/thiazide-diuretic-usage-and-risk-of-fracture-a-meta-analysis-of-cohort-studies
#5
X Xiao, Y Xu, Q Wu
Inconsistent findings in regard to association between thiazide diuretic use and the risk of fracture have been reported during the past decade. This updated meta-analysis, which pooled data from 11 qualified prospective designed studies, found that thiazides have a significant protective effect on fracture risk. INTRODUCTION: An updated comprehensive meta-analysis examine the association between thiazide diuretic use and therisk of fracture is needed. METHODS: Cohort studies regarding thiazide diuretic exposure and the risk of fracture, published from inception to May 1 2017, were identified through MEDLINE, EMBASE, SCOPUS, and the Cochrane Database of Systematic Reviews...
March 25, 2018: Osteoporosis International
https://www.readbyqxmd.com/read/29572286/add-on-antihypertensive-medications-to-angiotensin-aldosterone-system-blockers-in-diabetes-a-comparative-effectiveness-study
#6
Emily B Schroeder, Michel Chonchol, Susan M Shetterly, J David Powers, John L Adams, Julie A Schmittdiel, Gregory A Nichols, Patrick J O'Connor, John F Steiner
BACKGROUND AND OBJECTIVES: In individuals with diabetes, the comparative effectiveness of add-on antihypertensive medications added to an angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker on the risk of significant kidney events is unknown. DESIGN, SETTING PARTICIPANTS, & MEASUREMENTS: We used an observational, multicenter cohort of 21,897 individuals with diabetes to compare individuals who added β -blockers, dihydropyridine calcium channel blockers, loop diuretics, or thiazide diuretics to angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers...
March 23, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29566736/impact-of-diuretics-on-the-urate-lowering-therapy-in-patients-with-gout-analysis-of-an-inception-cohort
#7
Laura Ranieri, Carolina Contero, Maria-Luisa Peral, Irene Calabuig, Pedro Zapater, Mariano Andres
BACKGROUND: Diuretics have been associated with impaired response and refractoriness in gout, but whether this effect is still present with new urate-lowering drugs (ULD) and treat-to-target strategies is unknown. The aim of the present study was to assess the impact of the diuretics on the response to ULD in patients with gout.  METHODS: This was a retrospective analysis of an inception cohort. Participants were classified according to the type of ULD prescribed. We analysed the maximal dose of ULD (primary outcome variable), serum urate (SU) reduction, and the achievement of different SU targets (6 mg/dL, 5 mg/dL, and 4 mg/dL), according to the type of ULD prescribed and use of diuretics (loop and/or thiazide)...
March 22, 2018: Arthritis Research & Therapy
https://www.readbyqxmd.com/read/29565029/hypertension
#8
REVIEW
Suzanne Oparil, Maria Czarina Acelajado, George L Bakris, Dan R Berlowitz, Renata Cífková, Anna F Dominiczak, Guido Grassi, Jens Jordan, Neil R Poulter, Anthony Rodgers, Paul K Whelton
Systemic arterial hypertension is the most important modifiable risk factor for all-cause morbidity and mortality worldwide and is associated with an increased risk of cardiovascular disease (CVD). Fewer than half of those with hypertension are aware of their condition, and many others are aware but not treated or inadequately treated, although successful treatment of hypertension reduces the global burden of disease and mortality. The aetiology of hypertension involves the complex interplay of environmental and pathophysiological factors that affect multiple systems, as well as genetic predisposition...
March 22, 2018: Nature Reviews. Disease Primers
https://www.readbyqxmd.com/read/29530222/should-we-switch-from-bendrofluazide-to-chlorthalidone-as-the-initial-treatment-for-hypertension-a-review-of-the-available-medication
#9
Bruce Arroll, Henry Wallace
INTRODUCTION Thiazide diuretics are commonly prescribed in the treatment of hypertension. However, thiazide diuretics may not all be equal in their ability to reduce cardiovascular disease outcomes. AIM To determine if bendroflumethiazide/bendrofluazide, the most commonly used diuretic for hypertension in New Zealand, is as effective as other diuretics in terms of cardiovascular disease outcomes. METHODS Using recent reviews of thiazide-like (chlorthalidone or indapamide) and thiazide-type diuretics (hydrochlorothiazide and bendrofluazide) and a separate search of bendrofluazide, data on cardiovascular disease outcomes was extracted...
June 2017: Journal of Primary Health Care
https://www.readbyqxmd.com/read/29523524/genome-wide-association-study-identifies-the-hmgcs2-locus-to-be-associated-with-chlorthalidone-induced-glucose-increase-in-hypertensive-patients
#10
Sonal Singh, Caitrin W McDonough, Yan Gong, Wael A Alghamdi, Meghan J Arwood, Salma A Bargal, Leanne Dumeny, Wen-Yi Li, Mai Mehanna, Bradley Stockard, Guang Yang, Felipe A de Oliveira, Natalie C Fredette, Mohamed H Shahin, Kent R Bailey, Amber L Beitelshees, Eric Boerwinkle, Arlene B Chapman, John G Gums, Stephen T Turner, Rhonda M Cooper-DeHoff, Julie A Johnson
BACKGROUND: Thiazide and thiazide-like diuretics are first-line medications for treating uncomplicated hypertension. However, their use has been associated with adverse metabolic events, including hyperglycemia and incident diabetes mellitus, with incompletely understood mechanisms. Our goal was to identify genomic variants associated with thiazide-like diuretic/chlorthalidone-induced glucose change. METHODS AND RESULTS: Genome-wide analysis of glucose change after treatment with chlorthalidone was performed by race among the white (n=175) and black (n=135) participants from the PEAR-2 (Pharmacogenomic Evaluation of Antihypertensive Responses-2)...
March 9, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29521066/new-predictor-of-acute-necrotizing-pancreatitis-red-cell-distribution-width
#11
Mehmet Suat Yalçın, Adnan Tas, Banu Kara, Sehmus Olmez, Bunyamin Saritas
BACKGROUND: Acute pancreatitis (AP) is inflammation of the pancreas of various severity ranging from mild abdominal pain to mortality. AP may be classified as acute interstitial edematous pancreatitis (AEP) or acute necrotizing pancreatitis (ANP), according to the revised Atlanta criteria. Most of the patients with AP are AEP (75-85% of patients), while 15-25% of patients have ANP. The mortality rate is 3% in AEP and 15% in ANP. Thus, it is important to predict the severity of AP to decrease the morbidity and mortality...
February 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/29519546/incidence-of-hospital-acquired-hyponatremia-by-the-dose-and-type-of-diuretics-among-patients-with-acute-heart-failure-and-its-association-with-long-term-outcomes
#12
Masahiro Yamazoe, Atsushi Mizuno, Shun Kohsaka, Yasuyuki Shiraishi, Takashi Kohno, Ayumi Goda, Satoshi Higuchi, Mayuko Yagawa, Yuji Nagatomo, Tsutomu Yoshikawa
BACKGROUND: Diuretics are the cornerstone therapy for acute heart failure (AHF) but can lead to various electrolyte disturbances and inversely affect the patients' outcome. We aimed to evaluate whether (1) the dose of loop diuretics could predict hospital-acquired hyponatremia (HAH) during AHF treatment, (2) addition of thiazide diuretics could affect development of HAH, and (3) assess their impact on long-term outcomes. METHODS: We analyzed the subjects enrolled in the multicenter AHF registry (WET-HF)...
March 5, 2018: Journal of Cardiology
https://www.readbyqxmd.com/read/29512042/functional-status-improves-in-hypertensive-older-adults-the-long-term-effects-of-antihypertensive-therapy-combined-with-multicomponent-exercise-intervention
#13
Liliana C Baptista, André Pinto Amorim, João Valente-Dos-Santos, Aristides M Machado-Rodrigues, Manuel Teixeira Veríssimo, Raul A Martins
BACKGROUND: The increasing prevalence of functionally-limited hypertensive individuals highlights the need for interventions to reduce the burden of hypertension-aging-disability and to maximize the chances of healthy aging. AIM: This study aims to compare the effects of multicomponent exercise and different pharmacological treatments on functional status and cardiovascular risk outcomes in hypertensive older adults with comorbidities. METHODS: Participants (n = 96) engage in a 3 days/week multicomponent (aerobic + resistance) exercise program and for one of the following three conditions: (1) thiazide-related diuretics (TDs; n = 33, 69...
March 6, 2018: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/29508499/current-use-of-antihypertensive-drugs-in-japanese-patients-with-hypertension-analysis-by-age-group
#14
Takayuki Ishida, Akinori Oh, Shinzo Hiroi, Yukio Shimasaki, Takuya Tsuchihashi
AIM: To analyze the current use of antihypertensive drug classes in Japanese hypertensive patients stratified by age, highlighting differences between older and younger patients. METHODS: A nationwide medical database was used to evaluate antihypertensive use in patients (aged ≥20 years) who had received a prescription for one or more antihypertensive drug as an outpatient from April 2014 to March 2015. Patients (n = 59 867) were age-stratified into three groups: <65 years (28...
March 6, 2018: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/29500794/the-art-and-science-of-using-diuretics-in-the-treatment-of-heart-failure-in-diverse-clinical-settings
#15
Md Shahidul Islam
It is important to understand the rationale for appropriate use of different diuretics, alone or in combination, in different heart failure patients, under diverse clinical settings. Clinicians and nurses engaged in heart failure care, must be familiar with different diuretics, their appropriate doses, methods of administration, monitoring of the responses, and the side-effects. Inappropriate use of diuretics, both under-treatment and overtreatment, and poor follow-up can lead to failures, and adverse outcomes...
March 3, 2018: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29498881/-the-current-position-of-hydrochlorothiazide-among-thiazide-and-thiazide-like-diuretics
#16
Jiří Slíva
Thiazide and thiazide-like diuretics are an important group of drugs used in the treatment of essential arterial hyper-tension. While their beneficial therapeutic effect in monotherapy is evident, they are increasingly used in fixed combinations, particularly with ACE inhibitors or sartans. The aim of this article was to summarize the current status of hydrochlorothiazide and compare its effects with other substances in this subgroup of diuretics.Key words: diuretics - HCTZ - hydrochlorothiazide - hypertension - chlorthalidone - indapamide - thiazide...
2018: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/29497150/impact-of-long-term-potassium-supplementation-on-thiazide-diuretic-induced-abnormalities-of-glucose-and-uric-acid-metabolisms
#17
Jian-Liang Zhang, Hui Yu, Ying-Wei Hou, Ke Wang, Wen-Shan Bi, Liang Zhang, Qian Wang, Pan Li, Man-Li Yu, Xian-Xian Zhao
Treatment of hypertension with thiazide diuretics may trigger hypokalemia, hyperglycemia, and hyperuricemia. Some studies suggest simultaneous potassium supplementation in hypertensive patients using thiazide diuretics. However, few clinical studies have reported the impact of long-term potassium supplementation on thiazide diuretic-induced abnormalities in blood glucose and uric acid (UA) metabolisms. One hundred hypertensive patients meeting the inclusion criteria were equally randomized to two groups: IND group receiving indapamide (1...
March 1, 2018: Journal of Human Hypertension
https://www.readbyqxmd.com/read/29482694/pseudohypoaldosteronism-type-ii-a-young-girl-presented-with-hypertension-hyperkalemia-and-metabolic-acidosis
#18
Gul Hassan Sethar, Aisha Almoghawi, Nargis Khan, Wehad Altourah, Najat Mohammed Ashour
Pseudohypoaldosteronism (PHA) type II is an extremely rare disorder which presents with hypertension, hyperkalemia, and normal anion gap metabolic acidosis. PHA II is also known as familial hyperkalemic hypertension, Gordon syndrome, and chloride shunt syndrome. PHA II is an autosomal dominant disorder and is caused by mutation in WNK1, WNK4, CULLIN3, KLHL3, OSR, SPAK gene. The expression of these proteins is limited to the distal convoluted tube and collecting duct of the kidney. PHA II usually responds to salt restriction and thiazide diuretics...
March 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/29479446/use-of-acetazolamide-in-lithium-induced-nephrogenic-diabetes-insipidus-a-case-report
#19
Ricardo A Macau, Tiago Nunes da Silva, Joana Rego Silva, Ana Gonçalves Ferreira, Pedro Bravo
Lithium-induced nephrogenic diabetes insipidus (Li-NDI) is a rare and difficult-to-treat condition. A study in mice and two recent papers describe the use of acetazolamide in Li-NDI in 7 patients (a case report and a 6 patient series). We describe the case of a 63-year-old woman with bipolar disorder treated with lithium and no previous history of diabetes insipidus. She was hospitalized due to a bowel obstruction and developed severe dehydration after surgery when she was water deprived. After desmopressin administration and unsuccessful thiazide and amiloride treatment, acetazolamide was administrated to control polyuria and hydroelectrolytic disorders without significant side effects...
2018: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/29465713/hydrochlorothiazide-and-alternative-diuretics-versus-renin-angiotensin-system-inhibitors-for-the-regression-of-left-ventricular-hypertrophy-a-head-to-head-meta-analysis
#20
George C Roush, Ramy Abdelfattah, Steven Song, John B Kostis, Michael E Ernst, Domenic A Sica
BACKGROUND: Found in 36-41% of hypertension, elevated left ventricular mass (LVM) independently predicts cardiovascular events and total mortality. Conversely, drug-induced regression of LVM predicts improved outcomes. Previous studies have favored renin-angiotensin system inhibitors (RASIs) over other antihypertensives for reducing LVM but ignored differences among thiazide-type diuretics. From evidence regarding potency, cardiovascular events, and electrolytes, we hypothesized a priori that 'CHIP' diuretics [CHlorthalidone, Indapamide and Potassium-sparing Diuretic/hydrochlorothiazide (PSD/HCTZ)] would rival RASIs for reducing LVM...
February 20, 2018: Journal of Hypertension
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