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Resistant hypertension and sleep

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https://www.readbyqxmd.com/read/29047083/altered-redox-balance-in-the-development-of-chronic-hypoxia-induced-pulmonary-hypertension
#1
Nikki L Jernigan, Thomas C Resta, Laura V Gonzalez Bosc
Normally, the pulmonary circulation is maintained in a low-pressure, low-resistance state with little resting tone. Pulmonary arteries are thin-walled and rely heavily on pulmonary arterial distension and recruitment for reducing pulmonary vascular resistance when cardiac output is elevated. Under pathophysiological conditions, however, active vasoconstriction and vascular remodeling lead to enhanced pulmonary vascular resistance and subsequent pulmonary hypertension (PH). Chronic hypoxia is a critical pathological factor associated with the development of PH resulting from airway obstruction (COPD, sleep apnea), diffusion impairment (interstitial lung disease), developmental lung abnormalities, or high altitude exposure (World Health Organization [WHO]; Group III)...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28981991/sleep-behaviors-in-traditional-age-college-students-a-state-of-the-science-review-with-implications-for-practice
#2
Heather Owens, Becky Christian, Barbara Polivka
BACKGROUND AND PURPOSE: The purpose of this systematic review was to examine influences affecting sleep behavior in traditional-age college students and to advocate for improved sleep behavior assessments. DATA SOURCES: A literature search of CINAHL, MEDLINE, and PubMed databases was performed using the search terms "college students" and "sleep" in the title that were published in English from 1978 to 2016. CONCLUSIONS: The circadian clock is reset in traditional-age college students leading to delayed sleep times...
October 5, 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/28966594/the-role-of-the-autonomic-nervous-system-in-the-pathophysiology-of-obesity
#3
REVIEW
Daniela Guarino, Monica Nannipieri, Giorgio Iervasi, Stefano Taddei, Rosa Maria Bruno
Obesity is reaching epidemic proportions globally and represents a major cause of comorbidities, mostly related to cardiovascular disease. The autonomic nervous system (ANS) dysfunction has a two-way relationship with obesity. Indeed, alterations of the ANS might be involved in the pathogenesis of obesity, acting on different pathways. On the other hand, the excess weight induces ANS dysfunction, which may be involved in the haemodynamic and metabolic alterations that increase the cardiovascular risk of obese individuals, i...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28966076/sleep-apnea-metabolic-disease-and-the-cutting-edge-of-therapy
#4
Matthew Light, Karen McCowen, Atul Malhotra, Omar A Mesarwi
Obstructive sleep apnea (OSA) is common, and many cross-sectional and longitudinal studies have established OSA as an independent risk factor for the development of a variety of adverse metabolic disease states, including hypertension, insulin resistance, type 2 diabetes, nonalcoholic fatty liver disease, dyslipidemia, and atherosclerosis. Nasal continuous positive airway pressure (CPAP) has long been the mainstay of therapy for OSA, but definitive studies demonstrating the efficacy of CPAP in improving metabolic outcomes, or in reducing incident disease burden, are lacking; moreover, CPAP has variable rates of adherence...
September 28, 2017: Metabolism: Clinical and Experimental
https://www.readbyqxmd.com/read/28934188/effect-of-aldosterone-antagonists-on-obstructive-sleep-apnea-in-patients-with-resistant-hypertension-a-systematic-review-and-meta-analysis
#5
W-D Zhang, J-W Zhang, K-F Wu, X Chen, Y-P Wang, L-H Zhou, H-T Wang, S-M Chen
No abstract text is available yet for this article.
September 21, 2017: Journal of Human Hypertension
https://www.readbyqxmd.com/read/28863207/does-treating-obstructive-sleep-apnea-improve-control-of-tx-resistant-hypertension
#6
Steven Solum, Thomas Satre
Maybe. Treating obstructive sleep apnea with continuous positive airway pressure is associated with decreases in both systolic and diastolic blood pressure of 3 to 5 mm Hg in patients with treatment-resistant hypertension. The clinical significance of this small decrease hasn't been evaluated, however.
September 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28853425/obstructive-sleep-apnea-syndrome-osas-and-cardiovascular-system
#7
Carolina Lombardi, Eleonora Tobaldini, Nicola Montano, Anna Losurdo, Gianfranco Parati
There is increasing evidence of a relationship between Obstructive Sleep Apnea (OSA) and cardiovascular diseases. The strong association between OSA and arterial hypertension, in particular in patients with resistant hypertension and/or a non-dipping profile, has been extensively reported. The relationship between OSA and high blood pressure (BP) has been found independent from a number of confounders, but several factors may affect this relationship, including age and sex. It is thus important to better assess pathophysiologic and clinical interactions between OSA and arterial hypertension, also aimed at optimizing treatment approaches in OSA and hypertensive patients with co-morbidities...
August 28, 2017: La Medicina del Lavoro
https://www.readbyqxmd.com/read/28844889/aiding-sleep-in-type-2-diabetes-therapeutic-considerations
#8
REVIEW
Xiao Tan, Lieve van Egmond, Colin D Chapman, Jonathan Cedernaes, Christian Benedict
Insomnia and obstructive sleep apnoea (OSA) are more prevalent in patients with type 2 diabetes than in the general population. Both insomnia and OSA have been linked to cardiometabolic alterations (eg, hypertension, increased activity of the sympathetic nervous system, and systemic insulin resistance) that can exacerbate the pathophysiology of type 2 diabetes. Improvement of sleep in patients with diabetes could therefore aid the treatment of diabetes. To help health practitioners choose the best clinical tool to improve their patients' sleep without detrimentally affecting glucose regulation, this Review critically analyses the effects of common treatments for insomnia and OSA on both sleep and glucose metabolism in patients with type 2 diabetes...
August 24, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/28822508/prevalence-and-characteristics-of-resistant-hypertensive-patients-in-an-asian-population
#9
Rabia Naseem, Arsalan Majeed Adam, Fiza Khan, Adiya Dossal, Ibrahim Khan, Ammara Khan, Hannah Paul, Hafsa Jawed, Aisha Aslam, Faez Muhammad Syed, Muhammad Ahsen Niazi, Shehzeen Nadeem, Aruba Khan, Amber Zia, Mohammad Hussham Arshad
BACKGROUND: Resistant hypertension is a well-recognized clinical challenge yet there are no reported data on its prevalence in Pakistan. These patients are subjected to a higher risk of developing hypertensive complications. The objective of our study was to evaluate the prevalence and determinants of resistant hypertension in an Asian cohort of hypertensive patients. METHODS: This cross-sectional study was carried out among hypertensive patients visiting a tertiary care hospital in Karachi from September-December 2015...
July 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28805272/clinical-phenotype-of-south-east-asian-temporomandibular-disorder-patients-with-upper-airway-resistance-syndrome
#10
David K L Tay, Kenny P Pang
OBJECTIVE: To document the clinical phenotype of temporomandibular disorder (TMD) patients with concomitant upper airway resistance syndrome (UARS) in a South East Asian population. STUDY DESIGN: A multi-center prospective series of 86 TMD patients (26 men and 60 women / mean age 35.7 years) with UARS. All had excessive daytime sleepiness, high arousal index and apnea-hypopnea index (AHI)<5 RESULTS: The mean body mass index was 20.1, mean arousal index 16.2, mean respiratory disturbance index 19...
August 14, 2017: Journal of Oral Rehabilitation
https://www.readbyqxmd.com/read/28800040/effect-of-continuous-positive-airway-pressure-in-hypertensive-patients-with-obstructive-sleep-apnea-and-high-urinary-metanephrines
#11
Luisa Gilardini, Carolina Lombardi, Gabriella Redaelli, Paola Mattaliano, Paolo Fanari, Mauro Cornacchia, Massimo Scacchi, Stefania Mai, Patrizia Ferronato, Gianfranco Parati, Cecilia Invitti
OBJECTIVE: Some cases of pseudopheochromocytoma have been described among hypertensive patients with obstructive sleep apnea (OSA). This study examined whether a pathological rise of urinary metanephrines is a common feature in hypertensive OSA patients and, in such a case, whether the ventilation treatment during sleep (continuous or biphasic positive airway pressure) may normalize high metanephrines levels. METHODS: Patients with endocrine diseases, drug abuse, therapy with TCA and cardiovascular events in the previous 6 months were excluded...
August 10, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28767770/effects-of-continuous-positive-airway-pressure-on-blood-pressure-in-patients-with-resistant-hypertension-and-obstructive-sleep-apnea-a-systematic-review-and-meta-analysis-of-six-randomized-controlled-trials
#12
Qiang Lei, Yunhui Lv, Kai Li, Lei Ma, Guodong Du, Yan Xiang, Xuqing Li
Objective: To evaluate systematically the effects of continuous positive airway pressure (CPAP) on blood pressure in patients with resistant hypertension and obstructive sleep apnea (OSA). Methods: The Cochrane Library, PubMed, ScienceDirect, and the Web of Science were searched for studies investigating the effects of CPAP on blood pressure in patients with resistant hypertension and OSA. The selected studies underwent quality assessment and meta-analysis, as well as being tested for heterogeneity...
July 31, 2017: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
https://www.readbyqxmd.com/read/28728620/insulin-resistance-and-hypertension-in-obese-youth-with-sleep-disordered-breathing-treated-with-positive-airway-pressure-a-prospective-multicenter-study
#13
Sherri L Katz, Joanna E MacLean, Lynda Hoey, Linda Horwood, Nicholas Barrowman, Bethany Foster, Stasia Hadjiyannakis, Laurent Legault, Glenda N Bendiak, Valerie G Kirk, Evelyn Constantin
STUDY OBJECTIVES: There is evidence that cardiometabolic disease associated with obesity and sleep-disordered breathing (SDB) in adults is present in youth. SDB is often treated with positive airway pressure (PAP) in youth with obesity. Our aims were to determine: (1) the prevalence of cardiometabolic disease and (2) whether PAP improves markers of cardiometabolic disease, in youth with obesity and newly diagnosed moderate-severe SDB. METHODS: A prospective multicenter cohort study was conducted in youth (8 to 16 years old) with obesity, prescribed PAP therapy for newly diagnosed moderate-severe SDB...
September 15, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/28716800/relationship-between-vascular-resistance-and-sympathetic-nerve-fiber-density-in-arterial-vessels-in-children-with-sleep-disordered-breathing
#14
Anna Kontos, Kurt Lushington, James Martin, Quenten Schwarz, Ryan Green, David Wabnitz, Xiangjun Xu, Elke M Sokoya, Scott Willoughby, Mathias Baumert, Antonio Ferrante, Melissa La Forgia, Declan Kennedy
BACKGROUND: Sleep disordered breathing in children is associated with increased blood flow velocity and sympathetic overactivity. Sympathetic overactivity results in peripheral vasoconstriction and reduced systemic vascular compliance, which increases blood flow velocity during systole. Augmented blood flow velocity is recognized to promote vascular remodeling. Importantly, increased vascular sympathetic nerve fiber density and innervation in early life plays a key role in the development of early-onset hypertension in animal models...
July 17, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28697288/obstructive-sleep-apnoea-and-obesity
#15
Garun S Hamilton, Simon A Joosten
BACKGROUND: Obstructive sleep apnoea (OSA) and obesity are two common conditions affecting the Australian population; obesity is the major risk factor for OSA. OBJECTIVE: The objectives of this article are to review the interactions between obesity and OSA, including the increased cardiovascular risk, and highlight the importance of using OSA diagnosis as a critical time to address obesity itself and other cardiovascular risk factors. DISCUSSION: Snoring and symptoms of OSA frequently worsen during periods of rapid weight gain...
2017: Australian Family Physician
https://www.readbyqxmd.com/read/28680577/hypoxia-induced-pulmonary-hypertension-in-type-2-diabetic-mice
#16
Minglin Pan, Ying Han, Rui Si, Rui Guo, Ankit Desai, Ayako Makino
Hypoxia-induced pulmonary hypertension (HPH) is a progressive disease that is mainly caused by chronic exposure to high altitude, chronic obstructive lung disease, and obstructive sleep apnea. The increased pulmonary vascular resistance and increased pulmonary arterial pressure result in increased right ventricular afterload, leading to right heart failure and increased morbidity. There are several clinical reports suggesting a link between PH and diabetes, insulin resistance, or obesity; however, it is unclear whether HPH is associated with diabetes as a progressive complication in diabetes...
March 2017: Pulmonary Circulation
https://www.readbyqxmd.com/read/28658436/combined-aerobic-and-resistance-training-are-there-additional-benefits-for-older-hypertensive-adults
#17
Leandra G Lima, José T M Bonardi, Giulliard O Campos, Rodrigo F Bertani, Luria M L Scher, Júlio C Moriguti, Eduardo Ferriolli, Nereida K C Lima
OBJECTIVES: The objective of this study was to compare the effects of a combination of aerobic and resistance training to those of isolated aerobic training on blood pressure, body composition, and insulin sensitivity in hypertensive older adults. METHOD: Forty-four patients were randomly assigned to the aerobic group, resistance and aerobic group, and control group. Before and after 10 weeks, the following data were obtained: 24-hour ambulatory blood pressure data, abdominal circumference, waist circumference, body mass index, lean mass, fat mass, and insulin sensitivity...
June 2017: Clinics
https://www.readbyqxmd.com/read/28637078/-update-cardiovascular-sleep-medicine
#18
REVIEW
Benedikt Linz, Michael Böhm, Dominik Linz
The prevalence of sleep-disordered breathing (SDB) is high in patients with cardiovascular diseases. Typical symptoms like daytime sleepiness can be absent and those patients may report unspecific, therapy-resistant symptoms related to their underlying disease. Particularly sleep-related symptoms like nocturia, nocturnal dyspnea and pectangina can be present. Based on the results of recently published studies, the treatment of central sleep apnea in patients with symptomatic, systolic heart failure by adaptive servo-ventilation is no longer recommended...
June 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28613222/laboratory-evaluation-of-hypercoagulable-states-in-patients-with-central-retinal-vein-occlusion-who-are-less-than-56-years-of-age
#19
Qingyun Liu, J Michael Lahey, Rachel Karlen, Jay M Stewart
PURPOSE: To investigate whether the results of early tests for hypercoagulability are correlated with the development of central retinal vein occlusion risk factors later in life and to evaluate the necessity of these tests in younger patients. METHODS: This was a retrospective, observational case series. From January 1995 to December 2014, 55 patients aged below 56 years with central retinal vein occlusion (CRVO) were enrolled in the study. Laboratory evaluations for homocysteine, activated protein C resistance, protein C activity, protein S activity, antithrombin III activity, antiphospholipid antibodies, and anticardiolipin antibodies were obtained at the onset of CRVO...
April 24, 2017: Retina
https://www.readbyqxmd.com/read/28594706/diagnosis-of-tuberous-sclerosis-complex-in-a-patient-referred-for-uncontrolled-hypertension-and-renal-dysfunction-a-case-highlighting-the-importance-of-proper-diagnostic-work-up-of-hypertensive-patients
#20
Pantelis A Sarafidis, Athanasios Bikos, Charalampos Loutradis, Stergios Tzikas, Efstratios Vakirlis, Eugenia Avdelidou, Dimitrios Zafeiriou, Aikaterini Papagianni, Vasileios Vassilikos
: We report a case of a 39-year-old woman with resistant hypertension and renal dysfunction. The patient was hospitalized 3 months earlier for dyspnea at the Department of Cardiology, where she was diagnosed with heart failure (left ventricle injection fraction: 25-30%), pulmonary hypertension, chronic kidney disease (serum creatinine: 1.58 mg/dl), and resistant hypertension and discharged with optimal heart failure treatment. At presentation to our clinic, apart from uncontrolled hypertension for more than 10 years and history of pre-eclampsia and fetal loss, the patient had obesity (BMI: 38 kg/m) and facial fibromas...
June 7, 2017: Journal of Hypertension
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