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hypertension guideline treatment

Natasa Pilipovic-Broceta, Nadja Vasiljevic, Jelena Marinkovic, Nevena Todorovic, Janko Jankovic, Irena Ostric, Dimitra Kalimanovska-Ostric, Maja Racic
The objectives of this study were to evaluate patients' attitudes towards hypertension treatment according to the chronic care model and to assess the implementation of hypertension clinical guidelines in family medicine. The cross-sectional study was carried out in two randomly selected primary health care centers (Bijeljina and Prijedor), respectively in Bosnia and Herzegovina, covering the period between March and April 2016. This study sample consists of 791 respondents with hypertension purposing to measure specific actions and quality of care for hypertensive patients...
2018: PloS One
Ajmer Singh, Yatin Mehta
Heart failure (HF) is a complex clinical syndrome that results from any structural or functional impairment of ventricular filling or ejection of blood. American College of Cardiology Foundation / American Heart Association 2013 guidelines have classified HF into two categories: (i) HF with reduced (≤40%) ejection fraction (HFrEF) or systolic HF, and (ii) HF with preserved (≥50%) ejection fraction (HFpEF) or diastolic HF. Risk factors for HFpEF include age more than 70 years, female gender, hypertension, wide pulse pressure, diabetes mellitus, chronic renal insufficiency, left ventricular hypertrophy, atrial fibrillation, smoking, recent weight gain, and exercise intolerance...
April 2018: Journal of Anaesthesiology, Clinical Pharmacology
Jordan A Holmes, Roger F Anderson, Leroy G Hoffman, Timothy N Showalter, Mohit Kasibhatla, Sean P Collins, Michael A Papagikos, Brittany D Barbosa, Lori J Stravers, Zahra Mahbooba, Andrew Z Wang, Ronald C Chen
BACKGROUND: Prostate cancer survivors who receive androgen deprivation therapy (ADT) are at increased risk of cardiovascular disease. They require coordinated care between cancer specialist and primary care physicians (PCPs) to monitor for cancer control and manage cardiovascular risk factors. METHODS: We prospectively enrolled 103 men receiving ADT with radiotherapy from 7 institutions to assess cardiovascular risk factors and survivorship care. Medical records, fasting labs, and patient-reported outcomes using a validated instrument were assessed at baseline (pre-treatment) and 1 year post-RT...
August 9, 2018: International Journal of Radiation Oncology, Biology, Physics
Randall S Stafford
The recently released 2017 High Blood Pressure Guidelines depart from past guidelines in both their approach and recommendations. Developed by multiple health organizations, including the American College of Preventive Medicine, the guidelines continue to define normal blood pressure as <120/80 mmHg, but now define hypertension as ≥130/80 mmHg (previously ≥140/90 mmHg). This change categorizes 101 million Americans (46% of adults) as hypertensive (compared to 32% previously). The guidelines rely heavily on findings from the Systolic Blood Pressure Intervention Trial (SPRINT)...
August 6, 2018: American Journal of Preventive Medicine
Mariana L Henry, Jiangong Niu, Ning Zhang, Sharon H Giordano, Mariana Chavez-MacGregor
OBJECTIVES: This study sought to determine the rate of chemotherapy-related cardiotoxicity and to estimate adherence to recommendations for cardiac monitoring among breast cancer patients treated with chemotherapy. BACKGROUND: Heart failure (HF) is a known complication associated with cancer therapies. Little is known regarding the rate of chemotherapy-related cardiotoxicity and adherence to recommendations for cardiac monitoring among chemotherapy-treated breast cancer patients...
August 2018: JACC. Cardiovascular Imaging
Omar Mukhtar, Joseph Cheriyan, John R Cockcroft, David Collier, James M Coulson, Indranil Dasgupta, Luca Faconti, Mark Glover, Anthony M Heagerty, Teck K Khong, Gregory Y H Lip, Adrian P Mander, Mellone N Marchong, Una Martin, Barry J McDonnell, Carmel M McEniery, Sandosh Padmanabhan, Manish Saxena, Peter J Sever, Julian I Shiel, Julie Wych, Phil J Chowienczyk, Ian B Wilkinson
BACKGROUND: Ethnicity, along with a variety of genetic and environmental factors, is thought to influence the efficacy of antihypertensive therapies. Current UK guidelines use a "black versus white" approach; in doing so, they ignore the United Kingdom's largest ethnic minority: Asians from South Asia. STUDY DESIGN: The primary purpose of the AIM-HY INFORM trial is to identify potential differences in response to antihypertensive drugs used as mono- or dual therapy on the basis of self-defined ethnicity...
May 20, 2018: American Heart Journal
Raffaella Cancello, Davide Soranna, Amelia Brunani, Massimo Scacchi, Antonella Tagliaferri, Stefania Mai, Paolo Marzullo, Antonella Zambon, Cecilia Invitti
The treatment of obesity requires creating an energy deficit through caloric restriction and physical activity. Energy needs are estimated assessing the resting energy expenditure (REE) that in the clinical practice is estimated using predictive equations. In the present cross sectional study, we compared, in a large cohort of morbidly obese patients, the accuracy of REE predictive equations recommended by current obesity guidelines [Harris-Benedict, WHO/FAO/ONU and Mifflin-St Jeor (MJ)] and/or developed for obese patients (Muller, Muller BC, Lazzer, Lazzer BC), focusing on the effect of comorbidities on the accuracy of the equations...
2018: Frontiers in Endocrinology
Nikhil Srinivasapura Venkateshmurthy, Vamadevan S Ajay, Sailesh Mohan, Devraj Jindal, Shuchi Anand, Dimple Kondal, Nikhil Tandon, Malipeddi Bhaskara Rao, Dorairaj Prabhakaran
BACKGROUND: The proportion of patients with controlled hypertension (< 140/90 mmHg) is very low in India. Thus, there is a need to improve blood pressure management among patients with uncontrolled hypertension through innovative strategies directed at health system strengthening. METHODS: We designed an intervention consisting of two important components - an electronic decision support system (EDSS) used by a trained nurse care coordinator (NCC). Based on preliminary data, we hypothesized that this intervention will be able to reduce mean systolic blood pressure by 6...
August 7, 2018: Trials
Gerald W Smetana, Jennifer Beach, Lewis Lipsitz, Howard Libman
Hypertension is prevalent and the most important risk factor for cardiovascular disease. Controversy exists regarding the optimum threshold above which to begin antihypertensive therapy and the optimum target blood pressure once medication is begun. This controversy is particularly true for older patients, who may be more likely to benefit from treatment because of their higher risk for cardiovascular events, but may also be more at risk for adverse effects of treatment. Two guidelines published in 2017 address this issue...
August 7, 2018: Annals of Internal Medicine
Elvira O Gosmanova, Csaba P Kovesdy
Hypertension is present in most patients with end-stage kidney disease initiating dialysis and management of hypertension is a routine but challenging task in everyday dialysis care. End-stage kidney disease patients are uniquely heterogeneous individuals with significant variations in demographic characteristics, functional capacity, and presence of concomitant comorbid conditions and their severity. Therefore, these patients require personalized approaches in addressing not only hypertension but related illnesses, while also accounting for overall prognosis and projected longevity...
July 2018: Seminars in Nephrology
Ahmed H Abdelhafiz, Rachel Marshall, Joseph Kavanagh, Meguid El-Nahas
As the population ages, the prevalence of hypertension is increasing. Treatment of hypertension is associated with a reduction in cardiovascular risk. However, the optimal blood pressure targets in older people are not clearly defined due to paucity of randomised clinical trials specific to this age group. Areas covered: We performed a Medline and Embase search from 1998 to present for articles on the management of hypertension in older people published in English language. Expert commentary: The recent guidelines have suggested a lower blood pressure target of less than 130/80 mmHg...
July 2018: Expert Review of Endocrinology & Metabolism
Majla Cibo, Lejla Brigic, Sanela Tukulija, Nihad Kukavica, Amer Iglica, Merita Tiric-Campara
Introduction: The dominant global public health challenge are non-communicable diseases. According to World Health Organization (WHO) data. The fifth leading causes of death in FB&H are diseases of the heart and coronary arteries: stroke, acute myocardial infarction, cardiac arrest, cardiomyopathy and essential hypertension. The prevention of these diseases has great importance in improving health in B&H. Objective: The aim of this study is in estimation of one-year survival and left heart systolic function after the treatment...
June 2018: Acta Informatica Medica: AIM
Jean-Pierre Lebeau, Julie Biogeau, Maxime Carré, Alain Mercier, Isabelle Aubin-Auger, Emmanuel Rusch, Roy Remmen, Etienne Vermeire, Kristin Hendrickx
OBJECTIVES: To elaborate and validate operational definitions for appropriate inaction and for inappropriate inertia in the management of patients with hypertension in primary care. DESIGN: A two-step approach was used to reach a definition consensus. First, nominal groups provided practice-based information on the two concepts. Second, a Delphi procedure was used to modify and validate the two definitions created from the nominal groups results. PARTICIPANTS: 14 French practicing general practitioners participated in each of the two nominal groups, held in two different areas in France...
July 30, 2018: BMJ Open
Stephanie Wu, Audrey Chai, Sandra Arimie, Anilkumar Mehra, Leonardo Clavijo, Ray V Matthews, David M Shavelle
BACKGROUND: Mitral regurgitation (MR) is a common valvular disorder, occurring in up to 10% of the general population. Although surgery is the established treatment for primary MR, many patients do not receive appropriate therapy. The objective of this study was to determine the incidence and treatment pattern of patients with severe MR evaluated at a tertiary medical center and determine factors associated with receiving surgery. METHODS: All patients with moderate-severe and severe MR undergoing transthoracic echocardiography from 2011 to 2016 were identified...
July 24, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Federico Rea, Giovanni Corrao, Luca Merlino, Giuseppe Mancia
Aims: Guidelines support use of drug combinations in most hypertensive patients, and recently treatment initiation with two drugs has been also recommended. However, limited evidence is available on whether this leads to greater cardiovascular (CV) protection compared to initial monotherapy. Methods and results: Using the healthcare utilization database of the Lombardy Region (Italy), the 44 534 residents of the region (age 40-80 years) who in 2010 started treatment with one antihypertensive drug (n = 37 078) or a two-drug fixed-dose combination (FDC, n = 7456) were followed for 1 year after treatment initiation to compare the risk of hospitalization for CV disease associated with the two treatment strategies...
July 27, 2018: European Heart Journal
Katarzyna Skórkowska-Telichowska, Katarzyna Kropielnicka, Katarzyna Bulińska, Urszula Pilch, Marek Woźniewski, Andrzej Szuba, Ryszard Jasiński
BACKGROUND: An aggressive reduction of cardiovascular risk factors in patients with intermittent claudication (IC) is extremely important. OBJECTIVES: The aim of this study was to investigate patients' adherence to current guidelines for the recognition and reduction of atherosclerosis risk factors in peripheral arterial disease (PAD) in Poland. MATERIAL AND METHODS: The study included 126 patients with PAD stage II, according to the Fontaine Classification, who over a period of 2 years attended an angiological outpatient clinic and were referred for physical rehabilitation...
June 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Praew Kotruchin, Thapanawong Mitsungnern, Ratkamon Ruangsaisong, Supap Imoun, Chatlert Pongchaiyakul
INTRODUCTION: Hypertensive (HT) urgency is a common presentation in emergency room (ER). Although the practice guideline recommends against rapid blood pressure (BP) reduction, in medical practice, physicians usually attempt to timely reduce BP in order to avoid target organ damage. However, there is limited data in Asians. This study was designed to fill the gap of knowledge by using the dataset of the HT crises patients at a tertiary care center. AIM: To determine the characteristics, treatments, and outcomes of HT urgency patients during ER visit and at 2-week follow-up...
July 26, 2018: High Blood Pressure & Cardiovascular Prevention: the Official Journal of the Italian Society of Hypertension
Emanuela Mello Ribeiro Cavalari, Marcela Pessoa de Paula, Mariana Arruda, Nathália Carraro, Arthur Martins, Kamila de Souza, Maria Caroline Coelho, Nathalie Anne de Oliveira E Silva de Morais, Aline Barbosa Moraes, Leonardo Vieira Neto
CONTEXT: Although metabolic syndrome has been studied in patients with autonomous cortisol secretion (ACS), there are limited data for those with nonfunctioning adrenal incidentaloma (NFAI). OBJECTIVE: To assess metabolic syndrome frequency in NFAI patients and controls without adrenal adenoma according to World Health Organization (WHO), National Cholesterol Education Program- Adult Treatment Panel III (NCEP-ATP III), American Association of Clinical Endocrinologists/American College of Endocrinology (AACE/ACE) and International Diabetes Federation (IDF) criteria...
July 25, 2018: Clinical Endocrinology
Munekazu Ryuzaki
In the general population, hypertension (HT) is defined as systolic blood pressure (SBP) ≥140 mm Hg and/or diastolic blood pressure (DBP) ≥90 mm Hg. In dialysis patients, the definition is thought to be the same as in the general population. But there is no clear description about the definition of HT for dialysis patients, especially in peritoneal dialysis (PD) patients. The prevalence of HT in PD patients is much higher compared to the general population. The association of BP and cardiovascular (CV) mortality in PD patients who are not exposed to huge hemodynamic changes during hemodialysis (HD) has been inconsistently reported...
2018: Contributions to Nephrology
Jordan D Awerbach, Richard A Krasuski, Michael G W Camitta
There are >1.4 million adult congenital heart disease (CHD; ACHD) patients living in the United States. Coronary artery disease (CAD) is at least as prevalent in ACHD patients as in the general population and has become a leading cause of their mortality. In the majority of cases, CAD in the ACHD population is driven by the presence of traditional cardiovascular disease (CVD) risk factors. 80% of ACHD patients have at least one CVD risk factor. Hypertension (HTN), obesity and physical inactivity are frequently seen in both pediatric and adult patients with CHD...
July 21, 2018: Progress in Cardiovascular Diseases
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