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https://www.readbyqxmd.com/read/28346238/management-of-hypertension-in-2017-targets-and-therapies
#1
Monica Ahluwalia, Sripal Bangalore
PURPOSE OF REVIEW: Approximately one-fourth of the adult population is diagnosed with hypertension, which has been associated with increased cardiovascular morbidity and mortality including cardiovascular death, myocardial infarction, heart failure and stroke. Early detection and treatment is a key and can lead to a significant reduction in cardiovascular morbidity and mortality. RECENT FINDINGS: In this review, we discuss the management and treatment strategies in patients with hypertension in the current era...
March 24, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28343298/thiazide-increases-serum-calcium-in-anuric-patients-the-role-of-parathyroid-hormone
#2
Raquel F V Vasco, Eduardo T Reis, Rosa M A Moyses, Rosilene M Elias
We evaluated the effect of hydrochlorothiazide in a sample of anuric patients on hemodialysis and found an increase in serum calcium, which occurred only in those with parathyroid hormone >300 pg/ml. This finding highlights the extra-renal effect of this diuretic and a possible role of parathyroid hormone in the mechanism. PURPOSE: Thiazide diuretics are commonly used in patients with chronic kidney disease to treat hypertension. Their effects on calcium and bone metabolism are not well established, once calciuria may not fully explain levels of calcium and parathyroid hormone (PTH) in this population...
December 2017: Archives of Osteoporosis
https://www.readbyqxmd.com/read/28340822/risk-factors-of-hyperuricemia-after-renal-transplantation-and-its-long-term-effects-on-graft-functions
#3
S Eyupoglu, D Eyupoglu, Z Kendi-Celebi, S Akturk, A Tuzuner, K Keven, S Sengul
BACKGROUND: Hyperuricemia is a common complication in renal transplant recipients. Recent studies have suggested that hyperuricemia may contribute to the deterioration of graft function. METHODS: In this study, we aimed to investigate the risk factors related to hyperuricemia and the effects of hyperuricemia on graft dysfunction, graft survival, cardiovascular events, and mortality rates. Between the years 2005 and 2016, 141 renal transplantation patients with at least 5 years of follow-up were included in this retrospective cohort study...
April 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28331214/antihypertensive-medications-and-the-risk-of-kidney-stones-in-older-adults-a-retrospective-cohort-study
#4
R Todd Alexander, Eric McArthur, Racquel Jandoc, Blayne Welk, Jade S Hayward, Arsh K Jain, Branko Braam, Veit Flockerzi, Amit X Garg, Robert Ross Quinn
Antihypertensives are widely prescribed and could influence kidney stone risk by altering urinary calcium excretion. However, the impact of different classes of antihypertensives on kidney stone risk is unknown. To assess this impact, we conducted a retrospective, population-based cohort study using linked health administrative databases. Individuals aged >65 years who initiated one of the four antihypertensive classes (that is, angiotensin-converting enzyme inhibitors (ACEis)/angiotensin receptor blockers (ARBs), beta-blockers, calcium channel blockers or thiazide diuretics) were included...
March 23, 2017: Hypertension Research: Official Journal of the Japanese Society of Hypertension
https://www.readbyqxmd.com/read/28321269/exploratory-analysis-of-osteoarthritis-progression-among-medication-users-data-from-the-osteoarthritis-initiative
#5
Jeffrey B Driban, Grace H Lo, Charles B Eaton, Kate L Lapane, Michael Nevitt, William F Harvey, Charles E McCulloch, Timothy E McAlindon
BACKGROUND: We conducted an exploratory analysis of osteoarthritis progression among medication users in the Osteoarthritis Initiative to identify interventions or pathways that may be associated with disease modification and therefore of interest for future clinical trials. METHODS: We used participants from the Osteoarthritis Initiative with annual medication inventory data between the baseline and 36-month follow-up visit (n = 2938). Consistent medication users were defined for each medication classification as a participant reporting at all four annual visits that they were regularly using an oral prescription medication at the time of the visit...
December 2016: Therapeutic Advances in Musculoskeletal Disease
https://www.readbyqxmd.com/read/28290870/-selection-of-diuretic-therapy-in-cardiology-practice
#6
T E Morozova, I Y Yudina
Diuretic drugs - one of the most frequently prescribed groups of drugs in cardiology practice, primarily in patients with arterial hypertension (AH) and chronic heart failure (CHF). The article discusses the features of thiazide and loop diuretics, questions the selection of individual representatives of this class of drugs. Particular attention is paid to the loop diuretic torasemide, possessing, in addition to antihypertensive and diuretic effects, additional features such as the ability to reduce the activity of the renin-angiotensin-aldosterone system, reduce the severity of myocardial fibrosis, no negative influence on lipid and carbohydrate exchange, uric acid levels and blood electrolytes...
September 2016: Kardiologiia
https://www.readbyqxmd.com/read/28290800/-comparative-efficacy-of-the-influence-of-fixed-combinations-of-antihypertensive-drugs-that-block-the-renin-angiotensin-aldosterone-system-with-thiazide-diuretics-on-the-parameters-of-ambulatory-blood-pressure-monitoring
#7
O D Ostroumova, I A Garelik
AIM: to compare effects of fixed-dose combinations of antihypertensive drugs that block renin-angiotensin-aldosterone system (RAAS) with hydrochlorothiazide (HCT) on parameters of ambulatory blood pressure monitoring (ABPM). MATERIAL AND METHODS: Patients (n=50; 25 women, 25 men aged 40-75 years) with stage II essential hypertension who received no antihypertensive therapy for 12 weeks were randomized to receive once daily fixed-dose combinations of either valsartan/HCT (Val/HCT - group I) or quinapril/HCT (Quin/HCT - groupII) in starting doses of 80/12...
December 2016: Kardiologiia
https://www.readbyqxmd.com/read/28287295/-differential-diagnostic-dilemmas-after-use-of-an-out-of-date-antihypertensive-medication-case-report
#8
Péter Arányi, János Tomcsányi
Hydrochlorothiazide became one of the most commonly prescribed first-line antihypertensive medication, though its use is often complicated with serious side-effects. A 66-year-old female patient with a history of hypertension had suffered a transient loss of consciousness, and referred to our cardiology unit with an ST-segment elevation and giant negative T-waves in V1-2 ECG leads, long QT-segment and elevated serum creatine-kinase (5392 U/L) and troponin I (4,357 ng/ml) levels. Acute myocardial infarction was not proven (later coronarography revealed preserved coronary circulation), but severe hyponatraemia and hypokalaemia was detected, explaining a possible symptomatic seizure, and which could be accounted for a 25 mg daily hydrochlorothiazide antihypertensive treatment and - as a precipitating insult - a one-week history of gastroenteritis...
March 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28287293/-classical-antihypertensive-drugs-diuretics
#9
Viktor László Nagy
The diuretics are essential medicaments of antihypertensive therapy. They reduce blood pressure and cardiovascular events optimally. With increasing doses of thiazides and thiazide analogs do not come further powerful effect of reducing blood pressure or cardiovascular mortality and morbidity, but clearly elevate the side effects. Because of it, the minimum effective dose level and the fixed-dose combination therapy should be preferred. The use these drugs leads to especially positive outcome in elder patients, isolated systolic hypertension, heart failure, after stroke and in black population...
March 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28274929/hydrochlorothiazide-treatment-increases-the-abundance-of-the-nacl-cotransporter-in-urinary-extracellular-vesicles-of-essential-hypertensive-patients
#10
Ganesh Pathare, Omar A Z Tutakhel, Mark C V D Wel, Luke M Shelton, Jaap Deinum, Jacques W Lenders, Joost G J Hoenderop, René J M Bindels
The thiazide-sensitive NaCl cotransporter (NCC), located apically in distal convoluted tubule epithelia, regulates the fine-tuning of renal sodium excretion. Three isoforms of NCC are generated through alternative splicing of the transcript, of which the third isoform has been the most extensively investigated in pathophysiological conditions. The aim of this study was to investigate the effect of different anti-hypertensive treatments on the abundance and phosphorylation of all three NCC isoforms in urinary extracellular vesicles (uEVs) of essential hypertensive patients...
March 8, 2017: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/28274923/effect-of-diuretics-on-renal-tubular-transport-of-calcium-and-magnesium
#11
R Todd Alexander, Henrik Dimke
Calcium (Ca2+) and Magnesium (Mg2+) reabsorption along the renal tubule is dependent on distinct trans- and paracellular pathways. Our understanding of the molecular machinery involved is increasing. Ca2+ and Mg2+ reclamation in kidney is dependent on a diverse array of proteins, which are important for both forming divalent cation permeable pores and channels, but also for generating the necessary driving forces for Ca2+ and Mg2+ transport. Alterations in these molecular constituents lead to profound effects on tubular Ca2+ and Mg2+ handling...
March 8, 2017: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/28271257/outcomes-of-diuretic-use-in-pre-dialysis-ckd-patients-with-moderate-renal-deterioration-attending-tertiary-care-referral-center
#12
Yusra Habib Khan, Azmi Sarriff, Azreen Syazril Adnan, Amer Hayat Khan, Tauqeer Hussain Mallhi
INTRODUCTION: Diuretic therapy has been the mainstay of treatment in chronic kidney disease (CKD) patients, primarily for hypertension and fluid overload. Apart from their beneficial effects, diuretic use is associated with adverse renal outcomes. The current study is aimed to determine the outcomes of diuretic therapy. METHODOLOGY: A prospective observational study was conducted by inviting pre-dialysis CKD patients. Fluid overload was assessed by Bioimpedance analysis (BIA)...
March 7, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28260911/increased-risk-of-endotracheal-intubation-and-heart-failure-following-acute-myocardial-infarction-in-patients-with-urolithiasis-a-nationwide-population-based-study
#13
Shun-Ku Lin, Jui-Ming Liu, Ying-Hsu Chang, Yuan-Tien Ting, See-Tong Pang, Ren-Jun Hsu, Po-Hung Lin
BACKGROUND: Urolithiasis is a common urinary tract disease worldwide. It has been connected to systemic diseases, including hypertension, diabetes mellitus, metabolic syndrome, and cardiovascular disease. In the current study, we aimed to evaluate the relationship between urolithiasis and the complications of acute myocardial infarction (AMI). MATERIALS AND METHODS: Data were obtained from the Longitudinal Health Insurance Database 2005 of the National Health Insurance Research Database...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28260186/efficacy-of-zofenopril-vs-irbesartan-in-combination-with-a-thiazide-diuretic-in-hypertensive-patients-with-multiple-risk-factors-not-controlled-by-a-previous-monotherapy-a-review-of-the-double-blind-randomized-z-studies
#14
REVIEW
Stefano Omboni, Ettore Malacco, Claudio Napoli, Pietro Amedeo Modesti, Athanasios Manolis, Gianfranco Parati, Enrico Agabiti-Rosei, Claudio Borghi
Combinations between an angiotensin converting enzyme (ACE) inhibitor or an angiotensin II receptor blocker (ARB) and hydrochlorothiazide (HCTZ) are among the recommended treatments for hypertensive patients uncontrolled by monotherapy. Four randomized, double-blind, parallel group studies with a similar design, including 1469 hypertensive patients uncontrolled by a previous monotherapy and with ≥1 cardiovascular risk factor, compared the efficacy of a combination of a sulfhydryl ACE inhibitor (zofenopril at 30 or 60 mg) or an ARB (irbesartan at 150 or 300 mg) plus HCTZ 12...
March 4, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28259499/chlorthalidone-versus-amlodipine-for-hypertension-in-kidney%C3%A2-transplant-recipients-treated-with-tacrolimus-a%C3%A2-randomized-crossover-trial
#15
Arthur D Moes, Dennis A Hesselink, Anton H van den Meiracker, Robert Zietse, Ewout J Hoorn
BACKGROUND: Chlorthalidone is a very effective antihypertensive drug, but it has not been studied prospectively in kidney transplant recipients with hypertension. Recent data indicate that calcineurin inhibitors activate the thiazide-sensitive sodium chloride cotransporter, providing further rationale to test thiazides in this population. STUDY DESIGN: Randomized noninferiority crossover trial (noninferiority margin, -2.8mmHg). SETTING & PARTICIPANTS: Hypertensive kidney transplant recipients using tacrolimus (median duration, 2...
March 1, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28228057/intravenous-chlorothiazide-versus-enteral-metolazone-to-augment-loop-diuretic-therapy-in-the-intensive-care-unit
#16
Christopher J Michaud, Kendall C Mintus
BACKGROUND: In cases of loop diuretic resistance in the intensive care unit (ICU), recommendations for a specific second-line thiazide agent are lacking. OBJECTIVE: To compare the effects of intravenous chlorothiazide (CTZ) and enteral metolazone (MET) on urine output (UOP) when added to furosemide monotherapy therapy in critically ill adults. METHODS: This was a retrospective cohort study conducted in the medical, surgical, and cardiothoracic ICUs of a quaternary medical center...
April 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28222034/three-cases-of-gordon-syndrome-with-dominant-klhl3-mutations
#17
Ji Soo Park, Eujin Park, Hye Sun Hyun, Yo Han Ahn, Hee Gyung Kang, Il-Soo Ha, Hae Il Cheong
BACKGROUND: Gordon syndrome (GS) is a rare form of monogenic hypertension characterized by low renin hypertension, hyperkalemia, hyperchloremic metabolic acidosis, and normal glomerular filtration rate. To date, four genes causing GS have been identified as: WNK1, WNK4, CUL3, and KLHL3. CASE PRESENTATION: We report three cases of GS in two families. All patients presented with typical clinical features of GS and had a known dominant KLHL3 mutation. Oral thiazide treatment with low salt diet resulted in normalization of blood pressure and serum electrolytes in all three cases...
March 1, 2017: Journal of Pediatric Endocrinology & Metabolism: JPEM
https://www.readbyqxmd.com/read/28197292/chlorthalidone-plus-amiloride-reduces-the-central-systolic-blood-pressure-in-stage-1-hypertension-patients
#18
Leticia Aparecida Barufi Fernandes, Elizabeth do Espirito Santo Cestario, Luciana Neves Cosenso-Martin, Jose Fernando Vilela-Martin, Juan Carlos Yugar-Toledo, Flavio Danni Fuchs
BACKGROUND: Hypertension reduction strategies use blood pressure in the brachial artery as the primary endpoint. Individuals who achieve the target blood pressure reduction with antihypertensive treatment have residual cardiovascular risk attributed to the difference in pressure between the aorta and brachial artery. Antihypertensive treatment affects the intrinsic properties of the vascular wall and arterial stiffness markers and consequently the central pressure. Recent publications stress the importance of adequate control of the central compared to peripheral blood pressure...
December 2016: Cardiology Research
https://www.readbyqxmd.com/read/28182047/hyponatremia-a-rare-complication-of-gitelman-s-syndrome
#19
A Ganguli, J H Veis
Gitelman's syndrome (GS) is a rare autosomal recessive disorder caused by mutations in thiazide-sensitive NaCl cotransporter. We report a 49-year-old, normotensive lady with prolonged hypokalemia since her 20s who was diagnosed with GS at our renal clinic. During follow-up, she was found to have mild, asymptomatic, euvolemic hyponatremia with low serum uric acid, inappropriately high urine osmolality and sodium consistent with syndrome of inappropriate antidiuretic hormone-like presentation. Despite life-long urinary sodium losses, hyponatremia has rarely been reported in GS to be due to the primary disease process...
January 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28177101/-severe-hyperkalemia-in-patients-referred-to-an-emergency-departement-the-role-of-antialdosterone-drugs-and-of-renin-angiotensin-system-blockers
#20
Daria Motta, Giulio Cesano, Angelo Pignataro, Roberto Boero
We analyzed the clinical features and the factors associated with the presence of hyperkalemia (serum potassium >5.3 mmol/L) in a cohort of patients presenting to an Emergency Department. A total of 168 cases were observed (89 males and 79 females), mean age 77.512 years. Fifty-six patients were diabetics (33.3%), 51 patients had chronic kidney disease (30%) and 36 patients with cardiac failure (21.4%). Sixty-nine patients (41%) were treated with RAS-blockers (ACE-I n = 50; ARBs, n = 19). 65 subjects were taking loop diuretics (39%), 17 (10%) thiazides...
January 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
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