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hypertension guidelines

Tekin Akpolat, Mustafa Arici, Sule Sengul, Ulver Derici, Sukru Ulusoy, Sehsuvar Erturk, Yunus Erdem
Home blood pressure monitoring (HBPM), which integrates patients into their treatment program, is a self-management tool. The prevalence of home sphygmomanometer ownership and patient compliance with HBPM guidelines are not well known, especially in developing and underdeveloped countries. The aims of this study were to measure the prevalence of home sphygmomanometer ownership among hypertensive subjects through a nationwide field survey (PatenT2), to investigate the validation of sphygmomanometers and consistency of the user arm circumference and cuff size of the upper-arm device owned, as well as to compare blood pressure (BP) readings between hypertensive subjects who have or do not have a sphygmomanometer...
March 19, 2018: Hypertension Research: Official Journal of the Japanese Society of Hypertension
Chau Le Bao Ho, Monique Breslin, Jenny Doust, Christopher M Reid, Mark R Nelson
OBJECTIVES: In many current guidelines, blood pressure (BP)-lowering drug treatment for primary prevention of cardiovascular disease (CVD) is based on absolute risk. However, in clinical practice, therapeutic decisions are often based on BP levels alone. We sought to investigate which approach was superior by conducting a post hoc analysis of the Australian National Blood Pressure (ANBP) cohort, a seminal study establishing the efficacy of BP lowering in 'mild hypertensive' persons. DESIGN: A post hoc subgroup analysis of the ANBP trial results by baseline absolute risk tertile...
March 19, 2018: BMJ Open
Jochanan E Naschitz
Guidelines of arterial hypertension treatment based on individualised expected outcomes are not available for frail older persons. In this paper, we review the evidence, concerning management of arterial blood pressure (BP) in frail older patients. We focused on the best affordable methods for BP measurement; the age-related optimum BP; specific BP goals in agreement with the patients' general heath, frailty status, orthostatic and postprandial hypotension; balancing the benefits against risks of antihypertensive treatment...
March 19, 2018: Postgraduate Medical Journal
Mohammed N Alkhatib, Tamer Abd-Alghafoor, AlaaEldeen Elmassry, Loai Albarqouni, Bettina Böttcher, Maha Alfaqawi
BACKGROUND: Stroke is a leading cause of morbidity and mortality worldwide. The aim of this study was to assess the standard of care for patients with acute ischaemic stroke at the internal medicine department of Nasser Hospital, Gaza Strip. METHODS: For this retrospective clinical audit, we selected a random sample of 100 medical records for patients with stroke who were admitted to Nasser Hospital between January and August, 2016. Clinical practice was compared with the recommendations in the 2013 American Heart Association and American Stroke Association guidelines...
February 21, 2018: Lancet
Jochen Steppan, Natalia Diaz-Rodriguez, Viachaslau M Barodka, Daniel Nyhan, Erica Pullins, Traci Housten, Rachel L Damico, Stephen C Mathai, Paul M Hassoun, Dan E Berkowitz, Bryan G Maxwell, Todd M Kolb
Morbidity and mortality risk increase considerably for patients with pulmonary hypertension (PH) undergoing non-cardiac surgery. Unfortunately, there are no comprehensive, evidence-based guidelines for perioperative evaluation and management of these patients. We present a brief review of the literature on perioperative outcomes for patients with PH and describe the implementation of a collaborative perioperative management program for these high-risk patients at a tertiary academic center.
January 15, 2018: Curēus
Narges Safai, Bendix Carstensen, Henrik Vestergaard, Martin Ridderstråle
OBJECTIVES: To investigate the impact of a multifactorial treatment programme in a real-life setting on clinical outcomes and estimated cardiovascular disease (CVD) risk. DESIGN: A retrospective observational cohort study, using data from the electronic medical records and national registers. SETTING: Tertiary diabetes centre in Denmark. PARTICIPANTS: Patients with type 2 diabetes (n=4299) referred to a programme with focus on treatment of hyperglycaemia, hypertension and dyslipidaemia between 1 January 2001 and 1 April 2016...
March 17, 2018: BMJ Open
Michel Burnier
No abstract text is available yet for this article.
March 14, 2018: European Heart Journal
D Valenzuela, F Moya, M Luco, J L Tapia
50 years ago, Northway described Broncopulmonary Dysplasia (BPD) in preterm infants exposed to mechanical ventilation. Since then, their survival has increased, nevertheless a "new BPD" has appeared and its incidence has not diminished. One of the characteristics of this pathology is the the abnormal vascular remodeling, which in its most severe expression is known as Pulmonary Hyper tension (PH); with an incidence of 17% in patients with BPD, which is proportional to the severity of the disease (33% in severe BPD), and as mortality factor (up to 48% 2-year mortality in PH-BPD)...
December 2017: Revista Chilena de Pediatría
Aida Kamišalić, David Riaño, Tatjana Welzer
BACKGROUND: In medical practice, long term interventions are common and they require timely planning of the involved processes. Unfortunately, evidence-based statements about time are hard to find in Clinical Practice Guidelines (CPGs) and in other sources of medical knowledge. At the same time, health care centers use medical records and information systems to register data about clinical processes and patients, including time information about the encounters, prescriptions, and other clinical actions...
May 2018: Computer Methods and Programs in Biomedicine
Alexandra Wollum, Rose Gabert, Claire R McNellan, Jessica M Daly, Priscilla Reddy, Paurvi Bhatt, Miranda Bryant, Danny V Colombara, Pamela Naidoo, Belinda Ngongo, Anam Nyembezi, Zaino Petersen, Bryan Phillips, Shelley Wilson, Emmanuela Gakidou, Herbert C Duber
BACKGROUND: The HealthRise initiative seeks to implement and evaluate innovative community-based strategies for diabetes, hypertension and hypercholesterolemia along the entire continuum of care (CoC)-from awareness and diagnosis, through treatment and control. In this study, we present baseline findings from HealthRise South Africa, identifying gaps in the CoC, as well as key barriers to care for non-communicable diseases (NCDs). METHODS: This mixed-methods needs assessment utilized national household data, health facility surveys, focus group discussions, and key informant interviews in Umgungundlovu and Pixley ka Seme districts...
2018: PloS One
Wilbert S Aronow, William H Frishman
The 2017 American College of Cardiology/American Heart Association hypertension guidelines diagnose hypertension if systolic blood pressure (SBP) is ≥ 130 mmHg or diastolic blood pressure (DBP) is ≥ 80 mmHg. Increased BP is SBP 120-129 mmHg with DBP < 80 mmHg. Lifestyle measures should be used to treat individuals with increased BP. Lifestyle measures plus BP-lowering drugs should be used for secondary prevention of recurrent cardiovascular events in individuals with clinical cardiovascular disease (coronary heart disease, congestive heart failure, or stroke) and an average SBP ≥ 130 mmHg or an average DBP ≥ 80 mmHg...
March 13, 2018: Drugs
Duo Huang, Yang-Yang Cheng, Pak-Hei Chan, Jojo Hai, Kai-Hang Yiu, Hung-Fat Tse, Ka-Lam Wong, Katherine Fan, Ying Wah Li, Woon-Leung Ng, Cheuk-Wan Yim, Cheuk-Hon John Wong, Lai-Shan Tam, Priscilla C H Wong, Chi-Yuen Wong, Chup-Hei Ho, Alexander M H Leung, Chi-Chiu Mok, Ho Lam, Chak-Sing Lau, Tommy Cheung, Carmen Ho, Sharon W Y Law, Esther W Chan, Li-Xue Yin, Wen-Sheng Yue, Toi Meng Mok, Mario Alberto Evora, Chung-Wah Siu
Current guideline-recommended screening for pulmonary hypertension in patients with systemic sclerosis has not been evaluated in systemic lupus erythematosus (SLE), which is disproportionately prevalent in Asians. This multicentre, cross-sectional screening study aims to study the prevalence of pulmonary hypertension among SLE patients using these guidelines, and identify independent predictors and develop a prediction model for pulmonary hypertension in SLE patients. SLE patients from participating centres will undergo an echocardiography- and biomarker-based pulmonary hypertension screening procedure as in the DETECT study...
January 2018: ERJ Open Research
Thilo Burkard, Michael Mayr, Clemens Winterhalder, Licia Leonardi, Jens Eckstein, Annina Salome Vischer
OBJECTIVES: Standard operating procedures for office blood pressure measurement (OBPM) vary greatly between guidelines and studies. We aimed to compare the difference between a single OBPM and the mean of the three following measurements. Further, we studied how many patients with possible hypertension may be missed due to short-term masked hypertension (STMH) and how many might be overdiagnosed due to short-term white coat hypertension (STWCH). DESIGN AND SETTING: In this cross-sectional, single-centre trial, 1000 adult subjects were enrolled...
March 12, 2018: Heart: Official Journal of the British Cardiac Society
M Crowther, K van der Spuy, F Roodt, M B Nejthardt, J G Davids, J Roos, E Cloete, T Pretorius, G L Davies, J G van der Walt, C van der Westhuizen, M Flint, J L C Swanevelder, B M Biccard
Hypertension is not consistently associated with postoperative cardiovascular morbidity and is therefore not considered a major peri-operative risk factor. However, hypertension may predispose to peri-operative haemodynamic changes known to be associated with peri-operative morbidity and mortality, such as intra-operative hypotension and tachycardia. The objective of this study was to determine whether pre-operative hypertension was independently associated with haemodynamic changes known to be associated with adverse peri-operative outcomes...
March 12, 2018: Anaesthesia
Wessel M C M Vorselaars, Gerlof D Valk, Menno R Vriens, Jan Westerink, Wilko Spiering
OBJECTIVE: The aldosterone-to-renin ratio is widely used and is the recommended screening modality for primary aldosteronism by the Endocrine Society Guideline. However, studies on its diagnostic accuracy have been inconsistent, which is mainly because of methodological limitations. We set out to evaluate this diagnostic value by using a highly standardized study protocol, which is in line with the Endocrine Society Guideline recommendations regarding indications for screening, testing conditions and reference standards in daily clinical practice...
March 9, 2018: Journal of Hypertension
Simon James Howell
Purpose of Review: This review will examine the implications for perioperative management of new hypertension guidelines and place these in the context of findings from recent large observational studies. Recent Findings: Recent hypertension guidelines highlight the role of ambulatory blood pressure measurement with the implication that isolated preoperative blood pressure measurements are of limited value. There is emerging evidence from large observational studies that both preoperative and intraoperative hypotension are associated with increased risk...
2018: Current Anesthesiology Reports
Hamish C G Prosser, Omar Azzam, Markus P Schlaich
Resistant hypertension is commonly defined as office blood pressure above recommended target despite the use of optimal doses of at least three antihypertensive drugs including a diuretic. Australian guidelines recommend combination of blockers of the renin-angiotensin system, either ACE inhibitors or angiotensin receptor blockers, with calcium channel blockers and diuretics as the preferred triple therapy. A substantial proportion of hypertensive patients will require additional pharmacotherapy to achieve or get close to target blood pressure levels...
March 1, 2018: Heart, Lung & Circulation
Robert A Phillips, Jiaqiong Xu, Leif E Peterson, Ryan M Arnold, Joseph A Diamond, Adam E Schussheim
BACKGROUND: The lower rate of primary outcome events in the intensive treatment group in SPRINT (Systolic Pressure Intervention Trial) was associated with increased clinically significant serious adverse events (SAEs). In 2017, the American College of Cardiology and American Heart Association issued risk-based blood pressure treatment guidelines. The authors hypothesized that stratification of the SPRINT population by degree of future cardiovascular disease (CVD) risk might identify a group which could benefit the most from intensive treatment...
March 2, 2018: Journal of the American College of Cardiology
Prashant S Devrukhakar, Shiva Shankar M, Shankar G, Srinivas R
Timolol (TIM) is a potent β-adrenergic blocker, useful in treatment of ocular hypertension or open-angle glaucoma. Development and validation of stability indicating LCMS assay method for TIM was accomplished coherent with ICH guideline. Successful chromatographic separation of TIM with its four degradation products was attained by using gradient elution mode on reverse phase column using ammonium acetate buffer, pH 4.6 as mobile phase A and organic solvent as the mobile phase B. Chromatographic conditions were set such as 1...
February 28, 2018: Journal of Pharmaceutical and Biomedical Analysis
Paras Ali, Sofia Butt, Nazli Hossain
OBJECTIVE: To evaluate the practice of Eclampsia management at a tertiary care public sector hospital. PATIENTS & METHODS: We conducted criteria based audit of 93 Eclampsia patients admitted in Gynae unit III, Civil hospital and Dow University of Health Sciences Karachi, between 1st January 2016 and 31st December 2016. Management practices were assessed using evidence-based criteria for care. A clinical criteria for standards of care were developed from Royal College of Obstetrician & Gynecologist (RCOG/NICE) guidelines, World Health Organization (WHO) manual, twelve criteria were identified for the audit purpose...
January 2018: Pregnancy Hypertension
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