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https://www.readbyqxmd.com/read/29793070/intradialytic-blood-pressure-pattern-recognition-based-on-density-peak-clustering
#1
Feng Wang, Jing-Yi Zhou, Yu Tian, Yu Wang, Ping Zhang, Jiang-Hua Chen, Jing-Song Li
End-stage renal disease (ESRD) is the final stage of chronic kidney disease (CKD) and requires hemodialysis (HD) for survival. Intradialytic blood pressure (IBP) measurements are necessary to ensure patient safety during HD treatments and have critical clinical and prognostic significance. Studies on IBP measurements, especially IBP patterns, are limited. All related studies have been based on a priori knowledge and artificially classified IBP patterns. Therefore, the results were influenced by subjective concepts...
May 21, 2018: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/29792524/managing-comorbid-cardiovascular-disease-and-sleep-apnea-with-pharmacotherapy
#2
Jacek Wolf, Krzysztof Narkiewicz
Highly prevalent sleep disordered breathing (SDB) has been recognized as an independent cardiovascular disease (CVD) risk factor. Although these two entities often coexist, there is a shortage of sufficiently-powered studies testing the interplay between the course of sleep apnea and CVD pharmacotherapy. The mutual relationship between treated/untreated obstructive sleep apnea (OSA) with ongoing cardiovascular pharmacotherapies is an evident gap in clinical expertise. Areas covered: In this article, the authors review the available evidence and outline future research directions concerning the reciprocal relationship between the pharmacological treatment of CVD and SDB...
May 24, 2018: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/29791822/extracorporeal-membrane-oxygenation-for-severe-acute-respiratory-distress-syndrome
#3
Alain Combes, David Hajage, Gilles Capellier, Alexandre Demoule, Sylvain Lavoué, Christophe Guervilly, Daniel Da Silva, Lara Zafrani, Patrice Tirot, Benoit Veber, Eric Maury, Bruno Levy, Yves Cohen, Christian Richard, Pierre Kalfon, Lila Bouadma, Hossein Mehdaoui, Gaëtan Beduneau, Guillaume Lebreton, Laurent Brochard, Niall D Ferguson, Eddy Fan, Arthur S Slutsky, Daniel Brodie, Alain Mercat
BACKGROUND: The efficacy of venovenous extracorporeal membrane oxygenation (ECMO) in patients with severe acute respiratory distress syndrome (ARDS) remains controversial. METHODS: In an international clinical trial, we randomly assigned patients with very severe ARDS, as indicated by one of three criteria - a ratio of partial pressure of arterial oxygen (Pao2 ) to the fraction of inspired oxygen (Fio2 ) of less than 50 mm Hg for more than 3 hours; a Pao2 :Fio2 of less than 80 mm Hg for more than 6 hours; or an arterial blood pH of less than 7...
May 24, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29791175/-dyslipidemia-and-hypertension-what-to-worry-about-more
#4
Jan Václavík
Dyslipidemia is present in every other patient with arterial hypertension. With increasing blood pressure and cholesterol levels, the risk of cardiovascular events increases proportionally. Treatment of dyslipidemia appears to lower cardiovascular mortality to a greater extent than treatment of hypertension. A significant proportion of patients with dyslipidemia indicated for drug therapy are not treated at all or treated insufficiently and do not reach the target values. Concurrent treatment of hypertension and dyslipidemia reduces the incidence of cardiovascular events significantly more than treating only one of these diseases...
2018: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/29789952/carotid-body-ablation-a-new-target-to-address-central-autonomic-dysfunction
#5
REVIEW
Rodrigo Iturriaga
PURPOSE OF REVIEW: An abnormal heightened carotid body (CB) chemoreflex, which produces autonomic dysfunction and sympathetic overactivation, is the common hallmark of obstructive sleep apnea (OSA), resistant hypertension, systolic heart failure (HF), and cardiometabolic diseases. Accordingly, it has been proposed that the elimination of the CB chemosensory input to the brainstem may reduce the autonomic and cardiorespiratory alterations in sympathetic-associated diseases in humans. RECENT FINDINGS: A growing body of evidence obtained in preclinical animal models support that an enhanced CB discharge produces sympathetic hyperactivity, baroreflex sensitivity and heart rate variability impairment, breathing instability, hypertension, and insulin resistance...
May 22, 2018: Current Hypertension Reports
https://www.readbyqxmd.com/read/29789925/associations-of-polymorphisms-of-cyp2d6-and-cyp2c9-with-early-onset-severe-pre-eclampsia-and-response-to-labetalol-therapy
#6
Cheng-Juan Sun, Lin Li, Xue-Yan Li, Wei-Yuan Zhang, Xiao-Wei Liu
PURPOSE: Early onset preeclampsia (PPE) contributes to life-threatening maternal complications and fetal demise. Pharmacogenomics is a precision medicine, and metabolizing enzymes responsive to antihypertensive remains understudied. The aim of this study was to evaluate the associations of polymorphisms of cytochrome P450, family 2, subfamily D, polypeptide 6 (CYP2D6) and cytochrome P450, family 2, subfamily C, polypeptide 9 (CYP2C9) with PPE and the relationship among CYP2D6, CYP2C9 polymorphisms and response to labetalol therapy...
May 22, 2018: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29789795/clinical-and-experimental-evidences-of-hydrogen-sulfide-involvement-in-lead-induced-hypertension
#7
José Sérgio Possomato-Vieira, Victor Hugo Gonçalves-Rizzi, Regina Aparecida do Nascimento, Rodrigo Roldão Wandekin, Mayara Caldeira-Dias, Jessica Sabbatine Chimini, Maria Luiza Santos da Silva, Carlos A Dias-Junior
Lead- (Pb-) induced hypertension has been shown in humans and experimental animals and cardiovascular effects of hydrogen sulfide (H2 S) have been reported previously. However, no studies examined involvement of H2 S in Pb-induced hypertension. We found increases in diastolic blood pressure and mean blood pressure in Pb-intoxicated humans followed by diminished H2 S plasmatic levels. In order to expand our findings, male Wistar rats were divided into four groups: Saline, Pb, NaHS, and Pb + NaHS. Pb-intoxicated animals received intraperitoneally (i...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29789395/blood-pressure-attained-analysis-of-atach-2-trial
#8
Adnan I Qureshi, Yuko Y Palesch, Lydia D Foster, William G Barsan, Joshua N Goldstein, Daniel F Hanley, Chung Y Hsu, Claudia S Moy, Mushtaq H Qureshi, Robert Silbergleit, Jose I Suarez, Kazunori Toyoda, Haruko Yamamoto
BACKGROUND AND PURPOSE: We compared the rates of death or disability, defined by modified Rankin Scale score of 4 to 6, at 3 months in patients with intracerebral hemorrhage according to post-treatment systolic blood pressure (SBP)-attained status. METHODS: We divided 1000 subjects with SBP ≥180 mm Hg who were randomized within 4.5 hours of symptom onset as follows: SBP <140 mm Hg achieved or not achieved within 2 hours; subjects in whom SBP <140 mm Hg was achieved within 2 hours were further divided: SBP <140 mm Hg for 21 to 22 hours (reduced and maintained) or SBP was ≥140 mm Hg for at least 2 hours during the period between 2 and 24 hours (reduced but not maintained)...
May 22, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29789320/intensive-versus-standard-blood-pressure-treatment-improves-cardiovascular-outcomes-without-any-difference-in-patient-reported-outcomes
#9
REVIEW
David McCartney, Richard J McManus
No abstract text is available yet for this article.
June 2018: BMJ evidence-based medicine
https://www.readbyqxmd.com/read/29789273/insulin-resistance-is-related-to-psychiatric-disorders-among-obese-children
#10
Deniz Özalp Kızılay, Şermin Yalın Sapmaz, Semra Şen, Yekta Özkan, Betül Ersoy
OBJECTIVE: The current study aimed to investigate psychiatric consequences of obesity (OBy) and the relationship between metabolic syndrome components and psychiatric disorders in children. Our secondaryaim was to elucidate which of the anthropometric parameters or metabolic components were most strongly associated with psychiatric disorders. METHODS: The study included 88 obese(OB)and overweight (OW) children with a body mass index (BMI) greater than 85th percentile...
May 23, 2018: Journal of Clinical Research in Pediatric Endocrinology
https://www.readbyqxmd.com/read/29789210/should-first-blood-pressure-measurement-be-performed-in-the-newborn
#11
Inês Alves, Tânia Martins, Ana Luísa Neves, Esmeralda Rodrigues, Ana Teixeira, Caldas Afonso, Helena Pinto
Dilated cardiomyopathy is the most common form of cardiomyopathy and the main cause of cardiac transplantation in children and in adults. Infants and children have a wider spectrum of etiologies, hampering their identification. The most frequent initial manifestation of dilated cardiomyopathy is symptomatic heart failure during exercise or at rest (although many patients are asymptomatic). Some causes are potentially reversible, therefore the investigation should be carefully planned and immediately performed after diagnosis...
May 19, 2018: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29788258/is-the-plasma-aldosterone-to-renin-ratio-associated-with-blood-pressure-response-to-treatment-in-general-practice
#12
Sabine C Käyser, Bianca W M Schalk, Wim J C de Grauw, Tjard R Schermer, Reinier P Akkermans, Jacques W M Lenders, Jaap Deinum, Marion C J Biermans
Background: Individualized antihypertensive treatment based on specific biomarkers such as renin may lead to more effective blood pressure control in patients with newly diagnosed essential hypertension. Recent studies suggested that the plasma aldosterone-to-renin ratio (ARR) may also be a candidate predictor for this purpose. Objective: To assess whether the ARR is associated with the blood pressure response to antihypertensive treatment in patients with newly diagnosed hypertension...
May 19, 2018: Family Practice
https://www.readbyqxmd.com/read/29788097/hypertension-treatment-for-older-people-navigating-between-scylla-and-charybdis
#13
Simon Paul Conroy, Rudi Gerardus Johannes Westendorp, Miles D Witham
Hypertension is a common condition in older people, but is often one of many conditions, particularly in frail older people, and so is rarely managed in isolation in the real world-which belies the bulk of the evidence upon which is treatment decisions are often based. In this article, we discuss the issues of ageing, including frailty and dementia, and their impact upon blood pressure management. We examine the evidence base for managing hypertension in older people, and explore some therapeutic ideas that might influence treatment decisions and strategies, including shared decision making...
May 21, 2018: Age and Ageing
https://www.readbyqxmd.com/read/29788034/sleep-disorders-including-sleep-apnea-and-hypertension
#14
E M Van Ryswyk, S Mukherjee, C L Chai-Coetzer, A Vakulin, R D McEvoy
There is mounting evidence for an association between sleep disorders and hypertension. In obstructive sleep apnea (OSA) there are plausible biological reasons for the development of hypertension, and treatment of OSA results in modest (2-3 mmHg), adherence-dependent decreases in blood pressure (BP), with larger effects evident in those with resistant hypertension. However, prospective, population-based cohort studies have not yet convincingly demonstrated a link between OSA and incident hypertension, and adequately powered controlled trials of CPAP for the prevention or treatment or hypertension are lacking...
May 17, 2018: American Journal of Hypertension
https://www.readbyqxmd.com/read/29787809/eet-enhances-renal-function-in-obese-mice-resulting-in-restoration-of-mfn1-2-ho-1-signaling-and-decrease-in-hypertension-through-inhibition-of-sodium-chloride-co-transporter
#15
Joseph Schragenheim, Lars Bellner, Jian Cao, Shailendra P Singh, David Bamshad, John A McClung, Omri Maayan, Aliza Meissner, Ilana Grant, Charles T Stier, Nader G Abraham
BACKGROUND: We have previously reported that epoxyeicosatrienoic acid (EET) has multiple beneficial effects on renal and adipose tissue function, in addition to its vasodilatory action; it increases insulin sensitivity and inhibits inflammation. In an examination of the signaling mechanisms by which EET reduces renal and peri-renal fat function, we hypothesized that EET ameliorates obesity-induced renal dysfunction by improving sodium excretion, reducing the sodium-chloride cotransporter NCC, lowering blood pressure, and enhancing mitochondrial and thermogenic gene levels in PGC-1α dependent mice...
May 19, 2018: Prostaglandins & Other Lipid Mediators
https://www.readbyqxmd.com/read/29786410/percutaneous-deep-venous-arterialization-in-patients-with-critical-limb-ischemia-a-technical-note
#16
Steven Kum, Eline Huizing, Michiel A Schreve, Çagdas Ünlü, Roberto Ferraresi, Lasitha B Samarakoon, Daniel A van den Heuvel
Critical limb ischemia (CLI) is the presentation of end stage peripheral arterial disease and typically presents with rest pain, ulceration and gangrene. The outcome of conservative treatment is poor and often leads to amputations. Arterial revascularization plays an important role in amputation prevention. Unfortunately, a significant percentage of CLI patients cannot be revascularized and subsequently end up with a palliative amputation. This has led to the need and exploration of new treatment options in this no option subgroup of CLI...
May 22, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29786183/-hyperkalemia-as-a-limiting-factor-in-the-use-of-drugs-that-block-the-renin-angiotensin-aldosterone-system-raas
#17
Antonio Santoro, Marcora Mandreoli
Angiotensin-converting enzyme (ACE-I) inhibitors and ARBs have shown real efficacy in reducing blood pressure, proteinuria, in slowing the progression of chronic kidney disease (MRC) and in clinical improvement. in patients with heart failure, diabetes mellitus and ischemic heart disease. However, their use is limited by some side effects such as the increase in serum potassium (K), which can be particularly severe in patients with renal insufficiency. In the 23,000 patients followed by the PIRP project of the Emilia-Romagna Region, hyperkalaemia at the first visit (K> 5...
May 2018: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/29786039/role-of-soluble-st2-levels-and-beta-blockers-dosage-on-cardiovascular-events-of-patients-with-unselected-st-segment-elevation-myocardial-infarction
#18
Wei-Ping Huang, Xuan Zheng, Lei He, Xi Su, Cheng-Wei Liu, Ming-Xiang Wu
Background: Serum soluble ST2 (sST2) levels are elevated early after acute myocardial infarction and are related to adverse left ventricular (LV) remodeling and cardiovascular outcomes in ST-segment elevation myocardial infarction (STEMI). Beta-blockers (BB) have been shown to improve LV remodeling and survival. However, the relationship between sST2, final therapeutic BB dose, and cardiovascular outcomes in STEMI patients remains unknown. Methods: A total of 186 STEMI patients were enrolled at the Wuhan Asia Heart Hospital between January 2015 and June 2015...
June 5, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29785962/age-related-blood-pressure-sensitivity-to-aldosterone-in-blacks-and-whites
#19
Wanzhu Tu, Ruohong Li, Vivek Bhalla, George J Eckert, J Howard Pratt
Aldosterone sensitivity, defined as the magnitude of the association of plasma aldosterone concentration with blood pressure (BP), seems to be a function of plasma volume. It increases as plasma renin activity decreases, and it is more significant in blacks but less so in whites. Age is a strong determinant of BP, and an increase in aldosterone sensitivity could contribute to the increase in BP. In the present study, we tested the hypothesis that aldosterone sensitivity increases with age. We used observational data collected from normotensive blacks and whites enrolled in a prospective cohort study...
May 21, 2018: Hypertension
https://www.readbyqxmd.com/read/29785693/massive-transfusion-the-revised-assessment-of-bleeding-and-transfusion-rabt-score
#20
Bellal Joseph, Muhammad Khan, Michael Truitt, Faisal Jehan, Narong Kulvatunyou, Asad Azim, Arpana Jain, Muhammad Zeeshan, Andrew Tang, Terence O'Keeffe
BACKGROUND: Massive transfusion (MT) is a lifesaving treatment for trauma patients with hemorrhagic shock, assessed by Assessment of Blood Consumption (ABC) Score based on mechanism of injury, systolic blood pressure (SBP), tachycardia, and FAST exam. The aim of this study was to assess the performance of ABC score by replacing hypotension and tachycardia; with Shock Index (SI) > 1.0 and including pelvic fractures. METHODS: We performed a 2-year (2014-2015) analysis of all high-level trauma activations and excluded patients dead on arrival...
May 21, 2018: World Journal of Surgery
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