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Hypertension 2017

Andreas Palm, Bengt Midgren, Jenny Theorell-Haglöw, Magnus Ekström, Mirjam Ljunggren, Christer Janson, Eva Lindberg
OBJECTIVES: Adherence to continuous positive airway pressure (CPAP) in patients with obstructive sleep apnea (OSA) is crucial. Our aim was to identify protective and risk factors against the discontinuation of CPAP treatment in patients with OSA and to estimate the mortality risk in those who were non-adherent to CPAP therapy. METHODS: This was a registry-based cohort study from 37 centers across Sweden with OSA patients on CPAP in the Swedevox Swedish national registry between July 2010 and March 2017...
July 17, 2018: Sleep Medicine
Elham Hosseini, Mohsen Janghorbani
BACKGROUND: There is an ongoing discussion about the optimal diagnostic strategy for gestational diabetes mellitus (GDM). OBJECTIVE: To assess the magnitude of the association between GDM diagnosed with the one-step (International Association of Diabetes and Pregnancy Study Groups criteria) or two-step (Carpenter and Coustan criteria) approach and selected adverse pregnancy outcomes. SEARCH STRATEGY: Five electronic databases were searched up to October 2017 using Medical Subject Headings for each adverse outcome combined with the term "gestational diabetes...
August 12, 2018: International Journal of Gynaecology and Obstetrics
Riccardo Bertolo, Juan Garisto, Julien Dagenais, Daniel Sagalovich, Jose Agudelo, Robert Stein, Khaled Fareed, Tianming Gao, Amr Fergany, Jihad Kaouk
PURPOSE: To perform a single center evaluation comparing the perioperative, pathological and functional outcomes of robotic partial nephrectomy (RPN) for T1a renal masses < 2 cm vs T1a renal masses > 2 cm. MATERIALS AND METHODS: Propensity score 1:1 matching of queried patients was performed from the institutional RPN database (January 2007 - January 2017) by age, sex, race, BMI, Charlson's comorbidity Index, smoker status, diabetes, hypertension, hyperlipidemia, ASA score, eGFR, Chronic Kidney Disease stage and RENAL score...
July 3, 2018: Journal of Urology
Matthieu Heidet, Roland Amathieu, Etienne Audureau, Oriane Augusto, Violaine Nicolazo de Barmon, Amandine Rialland, David Schmitz, François Pierrang, Jean Marty, Charlotte Chollet-Xémard, Olivier Thirion, Line Jacob
INTRODUCTION: The management of acute upper gastrointestinal bleeding (UGIB) is challenging in patients with cirrhosis, as it is responsible for severe complications and high mortality rates. Tranexamic acid (TXA) may help control the bleeding by counterbalancing cirrhosis-related hyperfibrinolysis. Still, there is a lack of unbiased data to conclude on its efficacy. The aim of this study is to evaluate the efficacy of TXA in the early treatment of acute UGIB in patients with cirrhosis...
August 10, 2018: BMJ Open
Amihai Rottenstreich, Gabriel Levin, Geffen Kleinstern, Rani Haj Yahya, Misgav Rottenstreich, Simcha Yagel, Uriel Elchalal
INTRODUCTION: Previous reports have shown that suboptimal antenatal corticosteroids administration occurs in most cases. However, as multifetal gestations were either excluded or constituted a small proportion of the subjects in these studies, little is known about the patterns of use of antenatal corticosteroids in twin pregnancies. MATERIAL AND METHODS: We reviewed the records of women who received antenatal corticosteroids and delivered between 240/7 and 346/7 weeks of gestation during 2015-2017 at two university hospitals...
August 11, 2018: Acta Obstetricia et Gynecologica Scandinavica
Richard Ofori-Asenso, Ken Lee Chin, Andrea J Curtis, Ella Zomer, Sophia Zoungas, Danny Liew
Population aging along with the rising burden of chronic medical conditions (CMCs) is challenging the sustainability of health care systems globally. The authors sought to characterize contemporary patterns of multimorbidity among older adults (aged ≥65 years) in high-income countries (HICs). Medline, EMBASE, CINAHL, PsycINFO, and Web of Science were searched in January 2018 for English-language articles that reported the prevalence of multimorbidity (defined as co-occurrence of ≥2 CMCs in an individual without defining an index disease) among older adults in HICs, or the proportions with ≥3 or ≥5 CMCs...
August 10, 2018: Population Health Management
B Saka, A E Abilogoun-Chokki, S Akakpo, J Teclessou, G W Soga, G Mahamadou, W Gnassingbe, A Mouhari-Toure, K Kombate, E D Dosseh, V P Pitche
The aim of this study was to document the profile and causes of chronic leg ulcers (CLU) in patients hospitalized in Lomé, Togo. This retrospective study reviewed records from the dermatology departments (CHU Sylvanus Olympio and Campus, and the dermatology center of Gbossimé) from 2000 to 2017 and from the general surgery department of CHU Sylvanus Olympio from 2013 to 2017 to identify cases. In all, 125 cases of CLU were identified during the study period. The patients' mean age was 56.6 years and the sex ratio (M/F) was 0...
August 8, 2018: Médecine et Santé Tropicales
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
Sophie E Claudel, Joel Adu-Brimpong, Alnesha Banks, Colby Ayers, Michelle A Albert, Sandeep R Das, James A de Lemos, Tammy Leonard, Ian J Neeland, Joshua P Rivers, Tiffany M Powell-Wiley
BACKGROUND: Cardiovascular disease is a leading economic and medical burden in the United States (US). As an important risk factor for cardiovascular disease, hypertension represents a critical point of intervention. Less is known about longitudinal effects of neighborhood deprivation on blood pressure outcomes, especially in light of new hypertension guidelines. METHODS: Longitudinal data from the Dallas Heart Study facilitated multilevel regression analysis of the relationship between neighborhood deprivation, blood pressure change, and incident hypertension over a 9-year period...
August 6, 2018: American Heart Journal
Jing Lin, Xun-Yu Hong, Rong-Zu Tu
OBJECTIVES: This study aims to investigate the clinical value of uric acid in predicting adverse pregnancy outcomes (APOs) of women with hypertensive disorders of pregnancy. MATERIAL AND METHODS: A total of 180 pregnant women with HDP from September 2015 to January 2017 were selected for this study. These subjects were classified into two groups, according to serum uric acid level: high UA group (n = 137) and normal UA group (n = 43). In addition, 180 healthy pregnant women were selected and assigned as the control group (n = 180)...
2018: Ginekologia Polska
Rania Indu, Anjan Adhikari, Indira Maisnam, Piyali Basak, Tapas Kumar Sur, Anup Kumar Das
Purpose/Aim: Diabetes mellitus is associated with several comorbid conditions. Thus, often, diabetic patients are prescribed multiple drugs. Although multiple drugs help to combat various diseases, they also increase the propensity of drug interactions and adverse drug reactions. The present study thus tried to evaluate the comorbid conditions and concurrent medications associated with type 2 diabetic patients. It also aimed to address patient compliance for the medications provided to them...
July 2018: Perspectives in Clinical Research
Shangzhi Xiong, Hudson Berkhouse, Mary Schooler, William Pu, Anli Sun, Enying Gong, Lijing L Yan
PURPOSE OF REVIEW: This study aims to systematically review existing evidence on the effectiveness of mobile health technology (mHealth) interventions in addressing medication adherence among people with hypertension. RECENT FINDINGS: Twenty-one studies of mHealth interventions were included in the final review after systematic searching and screening of publications from 2000 to 2017 in PubMed, Web of Science, and Embase. Key features of the mHealth interventions include high intervention intensity, multifactorial components, and patient-centered approaches with tailored content and interaction...
August 7, 2018: Current Hypertension Reports
Jean Jacques Noubiap, Jobert Richie Nansseu, Ulrich Flore Nyaga, Paule Sandra Sime, Innocent Francis, Jean Joel Bigna
OBJECTIVE: We conducted the first systematic review and meta-analysis to estimate the specific prevalence of apparent treatment-resistant, pseudo-resistant and true-resistant hypertension among treated patients with hypertension globally. METHODS: We conducted a search in PubMed, EMBASE, Web of Science and Global Index Medicus to identify articles published from inception to 30 September 2017, and searched the reference list of retrieved articles. We used a random-effects model to estimate the prevalence of resistant hypertension across studies and heterogeneity was assessed via the χ² test on Cochran's Q statistic...
August 7, 2018: Heart: Official Journal of the British Cardiac Society
Sandra C Fuchs, Erno Harzheim, Cirano Iochpe, Caroline N de David, Marcelo R Gonçalves, Guilhermo P Sesin, Cassio M Costa, Leila B Moreira, Flavio D Fuchs
BACKGROUND: Hypertension is a growing problem worldwide, markedly in low- and middle-income countries, where the rate of control slightly decreased. The overall prevalence of hypertension in Brazil is 28.7% among adult individuals and 68.9% in the population aged 60 years and older, and less than a third of patients have controlled blood pressure (BP). The use of technologies-mobile phones and the internet-to implement interventions to reduce blood pressure can minimize costs and diminish cardiovascular risk...
August 7, 2018: JMIR Research Protocols
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
Dania Hirsch, Ilan Shimon, Yossi Manisterski, Nirit Aviran-Barak, Oren Amitai, Varda Nadler, Sandra Alboim, Vered Kopel, Gloria Tsvetov
PURPOSE: The most common etiology of Cushing's syndrome (CS) is an ACTH-producing pituitary adenoma (pitCS), reported as 2-3 times more frequent than primary adrenal CS (adrCS). We aimed to analyze and compare features of patients with pitCS and adrCS. METHODS: A retrospective file review of 196 consecutive patients (age 46.8 ± 15.6 years, 76% female) diagnosed with CS in 2000-2017 and followed for 5.2 ± 4.2 years; 109 (55.6%) had pitCS and 76 (38.8%) adrCS...
August 6, 2018: Endocrine
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
A H Rudresha, Tamojit Chaudhuri, K C Lakshmaiah, Govind K Babu, D Lokanatha, Linu Abraham Jacob, M C Suresh Babu, K N Lokesh, L K Rajeev
BACKGROUND: Renal cell carcinoma (RCC) is highly resistant to systemic chemotherapy, and historically a poor prognosis for metastatic disease has been reported, with a 5-year survival rate of <10%. Significant advances have been made in the last decade since the introduction of different tyrosine kinase inhibitors (TKIs) such as sunitinib, pazopanib, and sorafenib. Unfortunately, even though the TKIs have been used for a long time, there are very few published data regarding the experience of TKI therapy in metastatic RCC (mRCC) from India...
October 2017: Indian Journal of Cancer
Abdul Basit, Asher Fawwad, Huma Qureshi, A S Shera
OBJECTIVE: The second National Diabetes Survey of Pakistan (second NDSP) was planned to ascertain the updated prevalence of diabetes, pre-diabetes and associated risk factors at the national and provincial levels. RESEARCH DESIGN AND METHODS: The survey was conducted by using multistage clustering technique in all four provinces of Pakistan from February 2016 to August 2017. An estimated sample size of 10 800 was calculated using probability sampling and multistage stratified sampling technique...
August 5, 2018: BMJ Open
Zachary A Stacy, Sara K Richter
BACKGROUND: To review data from the pivotal phase III trials evaluating the efficacy and safety of direct oral anticoagulants (DOACs) versus warfarin for stroke prevention in patients with nonvalvular atrial fibrillation (NVAF), and to summarize the major findings with regards to patient subgroups that are at an increased risk for stroke or bleeding. METHODS: A PubMed literature search (January 2009 to January 2017) was performed using the terms 'dabigatran', 'rivaroxaban', 'apixaban', 'edoxaban', 'atrial fibrillation', 'RE-LY', 'ROCKET AF', 'ARISTOTLE', and 'ENGAGE AF-TIMI 48'...
September 2018: Therapeutic Advances in Cardiovascular Disease
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