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Resistant hypertension and sleep

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https://www.readbyqxmd.com/read/28104016/-effect-of-the-obstructive-sleep-apnea-hypopnea-syndrome-treatment-on-blood-pressure-in-patients-with-resistant-hypertension
#1
H W Wang, H M Liu, Z Y Zheng, Y Z Jia, H R Li
Objective: To investigate the effect of the treatments for obstructive sleep apnea hypopnea syndrome (OSAHS) on the resistant hypertension (RH) of patients. Methods: Eighty patients with OSAHS and RH (blood pressure could not be controlled under 140/90 mmHg (1 mmHg=0.133 kPa) even with more than three kinds of antihypertensive drugs including diuretics) received surgery or continuous positive airway pressure (CPAP) treatment. The results of polysomnography monitoring, ambulatory blood pressure monitoring, and the dosage of antihypertensive medication were recorded before and six months after the treatment...
January 7, 2017: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
https://www.readbyqxmd.com/read/28078487/the-role-of-the-nox4-derived-ros-mediated-rhoa-rho-kinase-pathway-in-rat-hypertension-induced-by-chronic-intermittent-hypoxia
#2
Wen Lu, Jing Kang, Ke Hu, Si Tang, Xiufang Zhou, Lifang Xu, Yuanyuan Li, Shuhui Yu
BACKGROUND: Obstructive sleep apnea syndrome, which is a risk factor for resistant hypertension, is characterized by chronic intermittent hypoxia (CIH) and is associated with many cardiovascular diseases. CIH elicits systemic oxidative stress and sympathetic hyperactivity, which lead to hypertension. Rho kinases (ROCKs) are considered to be major effectors of the small GTPase RhoA and have been extensively studied in the cardiovascular field. Upregulation of the RhoA/ROCK signaling cascade is observed in various cardiovascular disorders, such as atherosclerosis, pulmonary hypertension, and stroke...
January 11, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/27936906/metabolic-consequences-of-obstructive-sleep-apnea-in-adolescents-with-obesity-a-systematic-literature-review-and-meta-analysis
#3
Zachary W Patinkin, Richard Feinn, Melissa Santos
BACKGROUND: Adolescents who are obese are at high risk of developing obstructive sleep apnea (OSA). Although there is clear evidence associating OSA with metabolic dysfunction in adults, the evidence is less clear cut with adolescents. The purpose of this review was determine the association of sleep apnea with dyslipidemia, insulin resistance, cardiovascular disease risk, nonalcoholic fatty liver disease, and difficulty with weight loss in adolescents. METHODS: A systematic literature review using PubMed, Scopus, CINAHL, Google Scholar, and PsycINFO was performed and articles were screened and reviewed with an a priori protocol...
December 12, 2016: Childhood Obesity
https://www.readbyqxmd.com/read/27936533/endocrinology-update-testicular-hypogonadism
#4
Joel J Heidelbaugh
Testicular hypogonadism, or androgen deficiency, is defined as a clinical condition resulting from failure of the testes to produce physiologic levels of testosterone and a normal number of spermatozoa because of disruption of the hypothalamic-pituitary-gonadal axis. Testosterone deficiency (TD) is defined as a serum level less than 300 ng/dL on a morning total testosterone test. It is estimated that more than one-third of men 45 years and older have testosterone deficiency. Associated symptoms include decreased libido, erectile dysfunction, decreased physical stamina and strength, depressed mood, fatigue, increased visceral adiposity, sleep disturbance, and/or poor concentration and memory...
December 2016: FP Essentials
https://www.readbyqxmd.com/read/27924661/sleep-disordered-breathing-in-pregnancy-the-maternal-and-fetal-implications
#5
Shanthi Carnelio, Adam Morton, H David McIntyre
Sleep disordered breathing (SDB) which includes obstructive sleep apnoea (OSA) and upper airway resistance syndrome (UARS), has emerged as a risk factor for adverse maternal-foetal outcomes in pregnancy. Physiological changes of pregnancy predispose a woman 'at risk' towards developing SDB. The increasing incidence of OSA in pregnancy closely correlates with the population trends of obesity. Common screening tools validated in non-pregnant subjects including Epworth Sleepiness Scale (ESS) and Berlin Questionnaire (BQ) are poor predictors of SDB in pregnancy...
December 7, 2016: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/27923372/community-acquired-meningitis-caused-by-a-cg86-hypervirulent-klebsiella-pneumoniae-strain-first-case-report-in-the-caribbean
#6
Bénédicte Melot, Sylvain Brisse, Sébastien Breurec, Virginie Passet, Edith Malpote, Isabelle Lamaury, Guillaume Thiery, Bruno Hoen
BACKGROUND: Community-acquired bacterial meningitis due to Klebsiella pneumoniae has mainly been described in Southeast Asia and has a poor prognosis. Severe invasive infections caused by K. pneumoniae, including meningitis, are often due to hypervirulent strains (hvKP), which are characterized by capsular serotypes K1 and K2, a gene responsible for hypermucoviscosity, and the cluster for synthesis of the siderophore aerobactin. CASE PRESENTATION: A 55 year old man with a history of essential hypertension, benign prostate hyperplasia, hyperlipidemia, obstructive sleep apnea, and chronic alcoholism was admitted for meningitis due to Klebsiella pneumoniae with a wild-type susceptibility profile...
December 7, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27906840/renal-artery-denervation-for-treatment-of-patients-with-self-reported-obstructive-sleep-apnea-and-resistant-hypertension-results-from-the-global-symplicity-registry
#7
Dominik Linz, Giuseppe Mancia, Felix Mahfoud, Krzysztof Narkiewicz, Luis Ruilope, Markus Schlaich, Ingrid Kindermann, Roland E Schmieder, Sebastian Ewen, Bryan Williams, Michael Böhm
BACKGROUND: Sleep-disordered breathing, predominantly obstructive sleep apnea (OSA), is highly prevalent in patients with hypertension. OSA may underlie the progression to resistant hypertension, partly due to increased activation of the sympathetic nervous system. This analysis of patients with and without OSA evaluated the blood pressure (BP)-lowering effect of sympathetic modulation by renal denervation (RDN) in a real-world setting. METHODS: The Global SYMPLICITY Registry (NCT01534299) is a prospective, open-label, multicenter registry conducted worldwide to evaluate the safety and effectiveness of RDN in patients with uncontrolled hypertension...
January 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/27861249/the-antihypertensive-effects-of-aerobic-versus-isometric-handgrip-resistance-exercise
#8
Garrett I Ash, Beth A Taylor, Paul D Thompson, Hayley V MacDonald, Lauren Lamberti, Ming-Hui Chen, Paulo Farinatti, William J Kraemer, Gregory A Panza, Amanda L Zaleski, Ved Deshpande, Kevin D Ballard, Mohammadtokir Mujtaba, C Michael White, Linda S Pescatello
BACKGROUND: Aerobic exercise reduces blood pressure (BP) on average 5-7 mmHg among those with hypertension; limited evidence suggests similar or even greater BP benefits may result from isometric handgrip (IHG) resistance exercise. METHOD: We conducted a randomized controlled trial investigating the antihypertensive effects of an acute bout of aerobic compared with IHG exercise in the same individuals. Middle-aged adults (n = 27) with prehypertension and obesity randomly completed three experiments: aerobic (60% peak oxygen uptake, 30 min); IHG (30% maximum voluntary contraction, 4 × 2 min bilateral); and nonexercise control...
February 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/27837396/prognostic-importance-of-ambulatory-blood-pressure-monitoring-in-resistant-hypertension-is-it-all-that-matters
#9
REVIEW
Claudia R L Cardoso, Gil F Salles
PURPOSE OF REVIEW: This article reviews the current knowledge on the prognostic importance of ambulatory blood pressure (BP) monitoring parameters in patients with apparent treatment-resistant hypertension. RECENT FINDINGS: Although mean 24-h ambulatory BPs have been consistently established as better cardiovascular risk predictors than clinic (office) BPs in several clinical settings, and ambulatory BP monitoring is generally indicated in patients with resistant hypertension; there were only five previous longitudinal prospective studies that specifically evaluated the prognostic importance of ambulatory BP monitoring parameters in resistant hypertensive patients...
December 2016: Current Hypertension Reports
https://www.readbyqxmd.com/read/27823704/effect-of-different-types-of-exercise-on-sleep-quality-of-elderly-subjects
#10
José M T Bonardi, Leandra G Lima, Giulliard O Campos, Rodrigo F Bertani, Júlio C Moriguti, Eduardo Ferriolli, Nereida K C Lima
OBJECTIVE/BACKGROUND: There are still many gaps in research concerning the effect of different physical training modalities on sleep quality in the elderly population. Thus, the objective of the present study was to compare the quality of sleep of hypertensive elderly subjects submitted to two types of training (ie, aerobic exercise alone or combined aerobic and resistance training). PATIENTS/METHODS: Participants aged 60-75 years were randomized to three groups: aerobic group (AG), combined aerobic and resistance group (ARG), and control untrained group (CG)...
September 2016: Sleep Medicine
https://www.readbyqxmd.com/read/27813193/the-importance-of-and-potential-for-continuous-monitoring-of-intraocular-pressure
#11
REVIEW
Charles W McMonnies
Monitoring intraocular pressure (IOP) is a critically important part of glaucoma management; however, clinical tonometry predominantly involves sitting postures and is unable to detect variations in response to posture changes, muscular effort, deep respirations and during a wide range of activities, such as playing high wind-resistance instruments and wearing swimming goggles in addition to eye touching and rubbing. For example, the usefulness of 24-hour tonometric phasing may be increased, if nocturnal assessments included side and prone sleeping postures rather than being limited to supine posture tonometry...
November 3, 2016: Clinical & Experimental Optometry: Journal of the Australian Optometrical Association
https://www.readbyqxmd.com/read/27755119/sympathetic-nerves-and-hypertension-in-stress-sleep-apnea-and-caregiving
#12
Michael G Ziegler, Milos Milic
PURPOSE OF REVIEW: The sympathetic nervous system (SNS) mediates short-term increases in blood pressure. Evidence that psychosocial stress leads to chronic hypertension is mixed. The SNS activation found in obstructive sleep apnea (OSA), caregiving for a severely demented spouse, and obesity more specifically address whether SNS activation might lead to the metabolic syndrome and hypertension. RECENT FINDINGS: Obesity is associated with both increased SNS electrical activity and plasma norepinephrine...
January 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/27754279/hw-03-2-effect-of-cpap-on-the-treatment-of-resistant-hypertension
#13
Seong Hwan Kim
Resistant hypertension is defined as blood pressure that remains above 140/90 mmHg in spite of the concurrent use of three antihypertensive agents of different classes at optimal dosing, of which one should be a diuretic. Accordingly, it is not synonymous with uncontrolled hypertension. Among a variety of risk factors, obstructive sleep apnea (OSA), which is a common type of sleep-disordered breathing, has been recognized a well-established risk factor for resistant hypertension. Indeed, both European and American guidelines for the management of arterial hypertension stated that OSA is a modifiable cause of resistant hypertension...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27754274/sy-17-4-neuro-immune-communication-in-hypertension-a-new-therapeutic-angle
#14
Mohan Raizada
Hypertension (HTN) is the most prevalent modifiable risk for cardiovascular disease (CVD) and disorders directly influencing CVD (i.e. obesity, diabetes, chronic kidney disease, obstructive sleep apnea, etc.). About one billion people worldwide have HTN, with American adults having 90% lifetime risk of developing HTN. Despite aggressive campaign for lifestyle changes and advances in drug therapy, HTN remains an immense health, emotional, and economic challenge. This is due, in part, to the fact that ∼50% of HTN patients' blood pressure remains uncontrolled and ∼20% of HTN patients are resistant to or require > antihypertensive drugs...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27754015/br-04-1management-of-treatment-resistant-hypertension
#15
David John Webb
Treatment-resistant hypertension (TRH) is defined as the failure to achieve an office BP target of <140/90 mmHg (<130/80 mmHg in patients with chronic kidney disease (CKD) or diabetes) in patients with hypertension (HT), despite adherence to at least 3 antihypertensive medications at optimal tolerated doses, ideally including a diuretic (Calhoun et al., Circulation 2008). TRH identifies patients with hard-to-treat HT, who might benefit from specialist investigation and treatment. Although some studies put the prevalence of TRH as >10%, these levels may be inflated by white-coat hypertension and poor adherence...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27753946/os-07-02-differences-in-circadian-blood-pressure-variability-patterns-between-japanese-and-american-treatment-resistant-hypertensive-populations
#16
Kazuomi Kario, Deepak Bhatt, Sandeep Brar, George Bakris
OBJECTIVE: Dynamic changes in 24-hour ambulatory blood pressure (BP) are associated with basal autonomic function and cardiovascular risk. We examined the influence of ethnicity on these parameters by comparing ambulatory BP dynamics in Japanese, African American (AA), and white populations with treatment-resistant hypertension. DESIGN AND METHOD: Both HTN-Japan (N = 41) and SYMPLICITY HTN-3 (N = 384 white and 140 AA) enrolled patients with office systolic BP ≥ 160 mmHg and 24-hour ambulatory systolic BP ≥ 135 mmHg while on ≥3 antihypertensive medications...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27744513/effects-of-obesity-on-cardiovascular-hemodynamics-cardiac-morphology-and-ventricular-function
#17
REVIEW
Martin A Alpert, Jad Omran, Brian P Bostick
Obesity produces a variety of hemodynamic alterations that may cause changes in cardiac morphology which predispose to left and right ventricular dysfunction. Various neurohormonal and metabolic alterations commonly associated with obesity may contribute to these abnormalities of cardiac structure and function. These changes in cardiovascular hemodynamics, cardiac morphology, and ventricular function may, in severely obese patients, predispose to heart failure, even in the absence of other forms of heart disease (obesity cardiomyopathy)...
December 2016: Current Obesity Reports
https://www.readbyqxmd.com/read/27698070/arousal-from-sleep-and-sympathetic-excitation-during-wakefulness
#18
Keri S Taylor, Hisayoshi Murai, Philip J Millar, Nobuhiko Haruki, Derek S Kimmerly, Beverley L Morris, George Tomlinson, T Douglas Bradley, John S Floras
Obstructive apnea during sleep elevates the set point for efferent sympathetic outflow during wakefulness. Such resetting is attributed to hypoxia-induced upregulation of peripheral chemoreceptor and brain stem sympathetic function. Whether recurrent arousal from sleep also influences daytime muscle sympathetic nerve activity is unknown. We therefore tested, in a cohort of 48 primarily nonsleepy, middle-aged, male (30) and female (18) volunteers (age: 59±1 years, mean±SE), the hypothesis that the frequency of arousals from sleep (arousal index) would relate to daytime muscle sympathetic burst incidence, independently of the frequency of apnea or its severity...
December 2016: Hypertension
https://www.readbyqxmd.com/read/27681211/the-metabolic-syndrome-among-danish-seafarers-a-follow-up-study
#19
Jørgen Riis Jepsen, Hanna B Rasmussen
BACKGROUND: The metabolic syndrome (MS) represents a cluster of risk factors related to insulin resistance. Metabolic syndrome is a strong risk factor for chronic metabolic and cardiovascular diseases and is related to nutritional factors, sleep patterns, work-related stress, fatigue, and physical activity - all of which are critical issues at sea. We have previously demonstrated a MS prevalence of 24.2% in Danish seafarers. This study aimed to follow the trend of MS after 2 years' intervention...
2016: International Maritime Health
https://www.readbyqxmd.com/read/27643341/os-07-02-differences-in-circadian-blood-pressure-variability-patterns-between-japanese-and-american-treatment-resistant-hypertensive-populations
#20
Kazuomi Kario, Deepak Bhatt, Sandeep Brar, George Bakris
OBJECTIVE: Dynamic changes in 24-hour ambulatory blood pressure (BP) are associated with basal autonomic function and cardiovascular risk. We examined the influence of ethnicity on these parameters by comparing ambulatory BP dynamics in Japanese, African American (AA), and white populations with treatment-resistant hypertension. DESIGN AND METHOD: Both HTN-Japan (N = 41) and SYMPLICITY HTN-3 (N = 384 white and 140 AA) enrolled patients with office systolic BP ≥ 160 mmHg and 24-hour ambulatory systolic BP ≥ 135 mmHg while on ≥3 antihypertensive medications...
September 2016: Journal of Hypertension
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