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Resistant hypertension and sleep

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https://www.readbyqxmd.com/read/28822508/prevalence-and-characteristics-of-resistant-hypertensive-patients-in-an-asian-population
#1
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
#2
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
#3
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
#4
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
#5
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...
July 14, 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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
https://www.readbyqxmd.com/read/28557555/effect-of-obstructive-sleep-apnea-on-the-response-to-hypertension-therapy
#13
Michael G Ziegler, Milos Milic, Xiaojiong Lu, Munir Gharaibeh, Hamzeh Elayan
Obstructive sleep apnea (OSA) often precedes cardiovascular disease, partly due to treatment resistant hypertension. The nocturnal apneas of OSA trigger increased sympathetic nervous discharge during both sleep and wakefulness. Apneas also trigger cardiac release of the endogenous diuretic atrial natriuretic peptide. We hypothesized that treatment of the excess sympathetic nervous activity of OSA with a β1 blocker would lower 24 h blood pressure (BP) more than diuretic therapy. Subjects with OSA associated hypertension received 2 weeks of placebo followed by the β1 blocker nebivolol or hydrochlorothiazide (HCTZ) for 6 weeks in a blinded crossover study...
2017: Clinical and Experimental Hypertension: CHE
https://www.readbyqxmd.com/read/28474375/angiopoietin-2-and-soluble-tie-2-receptor-plasma-levels-in-children-with-obstructive-sleep-apnea-and-obesity
#14
David Gozal, Abdelnaby Khalyfa, Zhuanghong Qiao, Dale L Smith, Mona F Philby, Dorit Koren, Leila Kheirandish-Gozal
OBJECTIVE: Obstructive sleep apnea (OSA) is a prevalent condition, especially in children with obesity, and is associated with increased risk for metabolic syndrome (MetS). Angiopoietins have been identified as potential biomarkers of endothelial dysfunction and MetS. In adults, angiopoietin-2 (Ang-2) and its soluble receptor (sTie-2) are associated with diabetes, hypertension, and obesity and could be increased in children with OSA and obesity, particularly those with evidence of cardiometabolic alterations...
June 2017: Obesity
https://www.readbyqxmd.com/read/28458378/differences-in-dynamic-diurnal-blood-pressure-variability-between-japanese-and-american-treatment-resistant-hypertensive-populations
#15
Kazuomi Kario, Deepak L Bhatt, Sandeep Brar, George L Bakris
BACKGROUND: Dynamic diurnal changes in 24-h ambulatory systolic blood pressure (SBP) are associated with increased cardiovascular risk. We compared ambulatory BP dynamics in Japanese and American black and white populations with treatment-resistant hypertension.Methods and Results:Both HTN-Japan (n=41) and SYMPLICITY HTN-3 (n=384 white and n=140 black patients) enrolled patients with office SBP ≥160 mmHg and 24-h ambulatory SBP ≥135 mmHg while on ≥3 antihypertensive medications...
April 29, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28413970/optimizing-the-management-of-uncontrolled-resistant-hypertension-the-importance-of-sleep-apnoea-syndrome
#16
Jacek Wolf, Krzysztof Narkiewicz
Obstructive sleep apnoea (OSA) constitutes the most prevalent form of abnormal respiratory control during sleep in adults. Evidence linked OSA to cardiovascular disease, and the role of OSA in abnormal blood pressure (BP) control has been extensively studied. Although longitudinal trials suggest a causative role of OSA in the development of hypertension, the evidence is not fully consistent. Nasal continuous positive airway pressure (nCPAP) applied during sleep is well documented and a highly efficient therapeutic aid to eliminate OSA...
April 14, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28327653/association-of-aldosterone-excess-and-apnea-hypopnea-index-in-patients-with-resistant-hypertension
#17
Xiao Ke, Wenyu Guo, Hu Peng, Chengheng Hu, Henghong Zhang, Changnong Peng, Xiaoqing Wang
The present study was to investigate the association of aldosterone excess and apnea-hypopnea index (AHI) in patients with resistant hypertension. Patients with resistant hypertension were enrolled and baseline characteristics including plasma aldosterone concentration (PAC) and 24 h-urine aldosterone levels were collected and compared between groups with different degrees of AHI as assessed by polysomnography. Association of key variables and AHI was then evaluated by univariate and multiple linear regression analysis...
March 22, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28324596/blood-pressure-and-metabolic-changes-after-3-month-cpap-therapy-in-a-very-elderly-obese-with-severe-obstructive-sleep-apnea-a-case-report-and-review-of-the-literature
#18
Francesco Spannella, Federico Giulietti, Chiara Di Pentima, Francesca Elena Lombardi, Elisabetta Borioni, Riccardo Sarzani
Age is one of the main risk factor for the presence of obstructive sleep apnea (OSA). This syndrome is associated with hypertension, cardiovascular disease, cognitive impairment and metabolic abnormalities, such as type 2 diabetes. Continuous positive airway pressure (CPAP) represents the gold standard therapy, but its benefit is still to be determined in very elderly. We report the blood pressure and metabolic changes in a very elderly obese with severe OSA after 3-month CPAP therapy. We have evaluated a very elderly obese male affected by severe symptomatic OSA, poor controlled nocturnal hypertension and insulin resistance...
March 21, 2017: High Blood Pressure & Cardiovascular Prevention: the Official Journal of the Italian Society of Hypertension
https://www.readbyqxmd.com/read/28220472/renal-denervation-for-resistant-hypertension
#19
REVIEW
Giuseppe Coppolino, Anna Pisano, Laura Rivoli, Davide Bolignano
BACKGROUND: Resistant hypertension is highly prevalent among the general hypertensive population and the clinical management of this condition remains problematic. Different approaches, including a more intensified antihypertensive therapy, lifestyle modifications, or both, have largely failed to improve patients' outcomes and to reduce cardiovascular and renal risk. As renal sympathetic hyperactivity is a major driver of resistant hypertension, renal sympathetic ablation (renal denervation) has been recently proposed as a possible therapeutic alternative to treat this condition...
February 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28215245/effects-of-renal-sympathetic-denervation-on-blood-pressure-sleep-apnoea-severity-and-metabolic-indices-a-prospective-cohort-study
#20
Florrie Daniels, Simon De Freitas, Andrew Smyth, John Garvey, Conor Judge, John Joseph Gilmartin, Faisal Sharif
BACKGROUND: Catheter-based renal sympathetic denervation (RSD) significantly reduces blood pressure in patients with resistant hypertension, who commonly have obstructive sleep apnoea (OSA). These patients are considered particularly responsive to the antihypertensive effects of RSD, but additional benefits of metabolic control on sleep apnoea severity have not been thoroughly investigated. METHODS: The effect of RSD was evaluated prospectively in a cohort of patients with OSA (apnoea-hypopnea index (AHI) ≥15 events per hour and an Epworth Sleepiness Scale (ESS) score ≤9) and treatment resistant hypertension...
February 2017: Sleep Medicine
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