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Secondary hypertension

Joshua D Brown, Anand R Shewale, Jeffery C Talbert
BACKGROUND: Non-vitamin K antagonist oral anticoagulants (NOACs) are widely used for prevention of stroke secondary to nonvalvular atrial fibrillation (NVAF). Increased use of NOACs is partially a result of simplified regimens compared with warfarin, which has been associated with poor adherence and persistence to therapy. Few studies have assessed adherence to NOACs, especially using contemporary data now that multiple NOACs are available. OBJECTIVE: To evaluate adherence to NOACs in a cohort of newly diagnosed NVAF patients who are commercially insured...
November 2016: Journal of Managed Care & Specialty Pharmacy
Varun Agrawal, Jonathan B Wilfong, Christopher E Rich, Pamela C Gibson
Hyperoxaluria after Roux-en-Y gastric bypass (RYGB) increases the risk for kidney injury. Medical therapies for hyperoxaluria have limited efficacy. A 65-year-old female was evaluated for acute kidney injury [AKI, serum creatinine (Cr) 2.1 mg/dl, baseline Cr 1.0 mg/dl]. She did not have any urinary or gastrointestinal symptoms or exposure to nephrotoxic agents. Sixteen months prior to this evaluation, she underwent RYGB for morbid obesity. Her examination was unremarkable for hypertension or edema and there was no protein or blood on urine dipstick...
September 2016: Case Reports in Nephrology and Dialysis
Julia Nemiroff, Nopasak Phasukkijwatana, Veronika Vaclavik, Aaron Nagiel, Eric R Holz, David Sarraf
PURPOSE: To describe the multimodal imaging findings, including optical coherence tomography angiography analysis, and spectrum of etiologies associated with Amalric triangular choroidal infarction. METHODS: This study is a multicenter, retrospective, observational case series review of the clinical and multimodal imaging findings for six patients with Amalric triangular choroidal infarction. RESULTS: Six patients (10 eyes) with Amalric triangular choroidal infarction were enrolled...
October 11, 2016: Retinal Cases & Brief Reports
Damiano Rizzoni
OBJECTIVE: The dose-effect relationship of fixed-dose combinations of anti-hypertensive drugs has been only poorly explored. This pooled analysis investigates the dose-response relationship of fixed-dose lercanidipine + enalapril in patients with mild-to-moderate hypertension. RESEARCH DESIGN AND METHODS: This was an individual patient data analysis of four randomized studies (n = 2340). MAIN OUTCOME MEASURES: The primary efficacy variable was the change from baseline in sitting diastolic blood pressure (SDBP)...
October 2016: Current Medical Research and Opinion
Gregory Ian Bain, Simon Bruce Murdoch MacLean, Chong Jin Yeo, Egon Perilli, David M Lichtman
Kienböck disease is a condition that typically occurs in the "at-risk" patient, in the "at-risk" aspect of the proximal condyle of the "at-risk" lunate. In the active male, repetitive loading causes the stress fracture that commences in the single layer proximal subchondral bone plate. The lunate fracture commences at the point the lunate cantilevers over the edge of the distal radius, and then takes on the shape of the radius. We postulate that the stress fracture violates the parallel veins of the venous subarticular plexus-leading to localized venous hypertension and subsequent ischemia and edema of the fatty marrow...
November 2016: Journal of Wrist Surgery
Deepa Prasad, James P Strainic, Khyati Pandya, Peter C Kouretas, Ravi C Ashwath
We report a rare causal association between obstructed supracardiac totally anomalous pulmonary venous drainage and coronary sinus ostial atresia. Our 12-week-old patient developed venous myocardial infarction secondary to coronary venous hypertension because her sole route of coronary venous drainage was obstructed. She recovered after the obstruction was relieved by balloon dilation. Surgical repair then included anastomosis of the pulmonary venous confluence to the left atrium, ligation of the vertical vein, and unroofing of the coronary sinus...
October 2016: Texas Heart Institute Journal
Geeta Gyamlani, Carol M Headley, Adnan Naseer, Ganpat S Valaulikar, Stephen A Geraci
Primary aldosteronism (PA) is an important and commonly unrecognized cause of secondary hypertension. Idiopathic hyperaldosteronism and aldosterone-producing adenomas account for more than 95% of PA and are characterized, respectively, by bilateral or unilateral involvement of the adrenal glands. When there is suspicion for the presence of PA, a plasma aldosterone to renin ratio should be obtained initially. Localization to determine adrenal gland involvement is done by imaging, with computerized tomography or magnetic resonance imaging...
October 2016: American Journal of the Medical Sciences
Carsten P Bramlage, Mina Nasiri-Sarvi, Joan Minguet, Peter Bramlage, Gerhard Anton Müller
BACKGROUND AND AIMS: Arterial hypertension is a major cause of death worldwide. For the most part, treatment for hypertension can be performed on an outpatient basis. However, some patients also require inpatient treatment, and the contributing factors for this remain unknown. Therefore, the primary objective of the present study was to determine which patient characteristics are associated with inpatient treatment for arterial hypertension. METHODS: Here, we conducted a mono-centric study of 103 hypertensive subjects, who were treated as inpatients in the Department of Nephrology and rheumatology of the university medical faculty of Göttingen...
October 24, 2016: BMC Research Notes
Michael Loudin, Sharon Anderson, Barry Schlansky
BACKGROUND: Proximal or 'downhill' esophageal varices are a rare cause of upper gastrointestinal hemorrhage. Unlike the much more common distal esophageal varices, which are most commonly a result of portal hypertension, downhill esophageal varices result from vascular obstruction of the superior vena cava (SVC). While SVC obstruction is most commonly secondary to malignant causes, our review of the literature suggests that benign causes of SVC obstruction are the most common cause actual bleeding from downhill varices...
October 24, 2016: BMC Gastroenterology
Richard Ac Hughes, Ruth Brassington, Angela A Gunn, Pieter A van Doorn
BACKGROUND: Guillain-Barré syndrome (GBS) is an acute paralysing disease caused by inflammation of the peripheral nerves, which corticosteroids would be expected to benefit. OBJECTIVES: To examine the ability of corticosteroids to hasten recovery and reduce the long-term morbidity from GBS. SEARCH METHODS: On 12 January 2016, we searched the Cochrane Neuromuscular Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, and Embase...
October 24, 2016: Cochrane Database of Systematic Reviews
S Harikrishnan, G Sanjay, M Ashishkumar, Jaideep Menon, G Rajesh, R Krishna Kumar
BACKGROUND: Pulmonary hypertension (PH) is a disease associated with a high morbidity and mortality. There is paucity of data regarding PH from the developing countries including India. Idiopathic pulmonary arterial hypertension is the most important etiological factor in the western world, but PH secondary to rheumatic heart disease, chronic obstructive pulmonary disease and untreated congenital heart disease could well be the predominant causes in developing countries like India. The main objective of the PROKERALA study - Pulmonary hypertension Registry Of Kerala is to collect data regarding the etiology, practice patterns and one-year outcomes of patients diagnosed to have PH...
September 2016: Indian Heart Journal
M Agulnik, R L B Costa, M Milhem, A W Rademaker, B C Prunder, D Daniels, B T Rhodes, C Humphreys, S Abbinanti, L Nye, R Cehic, A Polish, C Vintilescu, T McFarland, K Skubitz, S Robinson, S Okuno, B A Van Tine
BACKGROUND: Soft tissue sarcomas (STSs) overexpress vascular endothelial growth factors (VEGF) and VEGF-receptors (VEGFR) activation have been associated with tumor aggressiveness. Tivozanib is a potent small molecule tyrosine kinase inhibitor against VEGFR1-3, with activity against PDGFRα/β and cKIT. The primary endpoint of this study was progression free survival (PFS) rate at 16 weeks. Secondary end points were overall survival (OS), response rate, safety and correlative studies...
October 22, 2016: Annals of Oncology: Official Journal of the European Society for Medical Oncology
Ozlem Korkmaz Dilmen, Eren Fatma Akcil, Abdulvahap Oguz, Hayriye Vehid, Yusuf Tunali
Since awake craniotomy (AC) has become a standard of care for supratentorial tumour resection, especially in the motor and language cortex, determining the most appropriate anaesthetic protocol is very important. The aim of this retrospective study is to compare the effectiveness of conscious sedation (CS) to "awake-asleep-awake" (AAA) techniques for supratentorial tumour resection. Forty-two patients undergoing CS and 22 patients undergoing AAA were included in the study. The primary endpoint was to compare the CS and AAA techniques with respect to intraoperative pain and agitation in patients undergoing supratentorial tumour resection...
October 19, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
N Kantaria, I Pantsulaia, I Andronikashvili, G Simonia
It has been known that salt-sensitivity of blood pressure is defined genetically as well as can be developed secondary to either decreased renal function or by influence of other environmental factors. The aim of the study was to evaluate the possible mechanism for the development of salt-sensitive essential hypertension in the population of Georgia. The Case-Control study included 185 subjects, 94 cases with Essential Hypertension stage I (JNC7) without prior antihypertensive treatment, and 91 controls. Salt-sensitivity test was used to divide both case and control groups into salt-sensitive (n=112) and salt-resistant (n=73) subgroups...
September 2016: Georgian Medical News
Anne-Maree Kelly, Sharon Klim
BACKGROUND: To determine the rate of all cause and cardiac death, new myocardial infarction (MI) or coronary revascularisation at over three years from index visit in emergency department chest pain patients without known coronary artery disease (CAD) at index presentation who had a negative electrocardiogram (ECG) and biomarker workup for acute coronary syndrome (ACS). METHODS: An unplanned sub-study of a prospective observational study of consecutive adult patients presenting to the ED with atraumatic chest pain (or equivalents)...
September 13, 2016: Heart, Lung & Circulation
Alessandro Mantovani, Lucia Mingolla, Riccardo Rigolon, Isabella Pichiri, Valentina Cavalieri, Giacomo Zoppini, Giuseppe Lippi, Enzo Bonora, Giovanni Targher
BACKGROUND: Recent studies suggested that nonalcoholic fatty liver disease (NAFLD) is associated with an increased prevalence of cardiovascular disease (CVD) in type 1 diabetes. We assessed whether NAFLD also predicts the risk of incident CVD events in type 1 diabetic adults. METHODS: We studied a retrospective cohort of 286 type 1 diabetic outpatients (mean age 43±14years; median duration of diabetes 17 [10-30] years) without secondary causes of chronic liver diseases, who were followed for a mean period of 5...
October 17, 2016: International Journal of Cardiology
Michael E Rezaee, Elizabeth L Nichols, Mandeep Sidhu, Jeremiah R Brown
BACKGROUND: Pulmonary hypertension (PH) is a well-recognized complication of left ventricular heart failure (HF). HYPOTHESIS: Differences exist in demographic, clinical, hemodynamic, and survival characteristics of patients with left ventricular HF who have combined postcapillary and precapillary PH (CpcPH), isolated postcapillary PH, or no PH. METHODS: A secondary data analysis was conducted using a large prospective database of patients undergoing right heart catheterization from 1994 to 2012...
October 21, 2016: Clinical Cardiology
Stefano Fiorucci, Angela Zampella, Giuseppe Cirino, Mariarosaria Bucci, Eleonora Distrutti
Bile acids are end product of cholesterol metabolism generated in the liver and released in the intestine. In addition to their role in nutrient absorption, bile acids are increasingly recognized as regulatory signals which exert their function beyond the intestine by activating a network of membrane and nuclear receptors. The best characterized of these bile acid activated receptors, GPBAR1 (also known as TGR5) and the Farnesosid-x-receptor (FXR) have also been detected in the vascular system and their activation mediate the vasodilatory effects of bile acids in the systemic and splanchnic circulation...
October 7, 2016: American Journal of Physiology. Heart and Circulatory Physiology
Lee M Bass, Stanley Kim, Riccardo Superina, Saeed Mohammad
Portal hypertension secondary to portal vein obstruction following liver transplant occurs in 5%-10% of children. Jejunal varices are uncommon in this group. We present a case series of children with significant GI blood loss, negative upper endoscopy, and jejunal varices detected by CE. Case series of patients who had CE for chronic GI blood loss following liver transplantation. Three patients who had their initial transplants at a median age of 7 months were identified at our institution presenting at a median age of 8 years (range 7-16 years) with a median Hgb of 2...
October 20, 2016: Pediatric Transplantation
Jeffrey Gnerre, Yankai Sun, Andrzej Jedynak, Anthony Gilet
Gallbladder varices are a rare form of collateralization that develop in patients with portal hypertension. We present here a case of gallbladder varices accurately diagnosed by contrast enhanced CT imaging of the abdomen and confirmed by Color Doppler Sonography. A 76-year-old patient with hepatocellular carcinoma developed portal vein thrombosis due to tumor extension during the course of treatment and was incidentally discovered to have gallbladder varices. While most commonly asymptomatic, gallbladder varices are associated with increased risk of massive bleeding, either spontaneously or during cholecystectomy...
May 2016: Journal of Radiology Case Reports
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