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Uncontrolled HTN

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https://www.readbyqxmd.com/read/29446840/uncontrolled-blood-pressure-affects-atrial-remodeling-and-adverse-clinical-outcome-in-paroxysmal-atrial-fibrillation
#1
Masashi Kamioka, Naoko Hijioka, Yoshiyuki Matsumoto, Minoru Nodera, Takashi Kaneshiro, Hitoshi Suzuki, Yasuchika Takeishi
BACKGROUND: To investigate the impact of uncontrolled blood pressure (BP) on left atrial (LA) remodeling and clinical outcome after pulmonary vein isolation (PVI) in paroxysmal atrial fibrillation (AF). METHODS: One hundred and one symptomatic paroxysmal AF patients (85 males, 62.2±8.4 year-old) who underwent successful PVI were classified as follows: group 1 (n = 46), no hypertension (HTN); group 2 (n = 36), HTN with controlled BP; and group 3 (n = 19), HTN with uncontrolled BP...
February 15, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29301473/blood-pressure-control-over-time-in-childhood-onset-systemic-lupus-erythematous
#2
P O Avar Aydin, J Shan, H I Brunner, M M Mitsnefes
Introduction Hypertension (HTN) is prevalent in patients with systemic lupus erythematosus (SLE) and causes early cardiovascular aging and progression of renal and cardiac disease. The aim of this longitudinal retrospective study was to evaluate the prevalence of HTN, the follow-up blood pressure trends, and risk factors for HTN in a population-based cohort with childhood-onset SLE (cSLE). Methods Demographic and clinical data of consecutive visits from the baseline to the last visit were extracted from electronic medical records of patients with cSLE...
January 1, 2018: Lupus
https://www.readbyqxmd.com/read/29224639/a-multinational-clinical-approach-to-assessing-the-effectiveness-of-catheter-based-ultrasound-renal-denervation-the-radiance-htn-and-require-clinical-study-designs
#3
RANDOMIZED CONTROLLED TRIAL
Laura Mauri, Kazuomi Kario, Jan Basile, Joost Daemen, Justin Davies, Ajay J Kirtane, Felix Mahfoud, Roland E Schmieder, Michael Weber, Shinsuke Nanto, Michel Azizi
Catheter-based renal denervation is a new approach to treat hypertension via modulation of the renal sympathetic nerves. Although nonrandomized and small, open-label randomized studies resulted in significant reductions in office blood pressure 6months after renal denervation with monopolar radiofrequency catheters, the first prospective, randomized, sham-controlled study (Symplicity HTN-3) failed to meet its blood pressure efficacy end point. New clinical trials with new catheters have since been designed to address the limitations of earlier studies...
January 2018: American Heart Journal
https://www.readbyqxmd.com/read/29219082/task-shifting-in-the-management-of-hypertension-in-kinshasa-democratic-republic-of-congo-a-cross-sectional-study
#4
Aimée M Lulebo, Didine K Kaba, Silvestre E-H Atake, Mala A Mapatano, Eric M Mafuta, Julien M Mampunza, Yves Coppieters
BACKGROUND: The Democratic Republic of the Congo (DRC) is characterized by a high prevalence of hypertension (HTN) and a high proportion of uncontrolled HTN, which is indicative of poor HTN management. Effective management of HTN in the African region is challenging due to limited resources, particularly human resources for health. To address the shortage of health workers, the World Health Organization (WHO) recommends task shifting for better disease management and treatment. Although task shifting from doctors to nurses is being implemented in the DRC, there are no studies, to the best of our knowledge, that document the association between task shifting and HTN control...
December 4, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29208254/assessing-mobile-health-capacity-and-task-shifting-strategies-to-improve-hypertension-among-ghanaian-stroke-survivors
#5
Michelle Nichols, Fred Stephen Sarfo, Arti Singh, Suparna Qanungo, Frank Treiber, Bruce Ovbiagele, Raelle Saulson, Sachin Patel, Carolyn Jenkins
BACKGROUND: There has been a tremendous surge in stroke prevalence in sub-Saharan Africa. Hypertension (HTN), the most potent, modifiable risk factor for stroke, is a particular challenge in sub-Saharan Africa. Culturally sensitive, efficacious HTN control programs that are timely and sustainable are needed, especially among stroke survivors. Mobile health (mHealth) technology and task-shifting offer promising approaches to address this need. METHODS: Using a concurrent triangulation design, we collected data from stroke survivors, caregivers, community leaders, clinicians and hospital personnel to explore the barriers, facilitators and perceptions toward mHealth related to HTN management among poststroke survivors in Ghana...
December 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/29184342/risk-factors-vascular-lesion-distribution-outcome-and-recurrence-of-strokes-due-to-intracranial-atherosclerosis-one-year-data-from-hyderabad-stroke-registry
#6
Raghu Ram, Subhash Kaul, Suvarna Alladi, Jabeen S Afshan, T Surya Prabha, Abhijeet Kohat, Swetha Tandra, Jyotsna Y Rani
Background: Intracranial atherosclerotic stenosis (ICAS) is a common cause of ischemic stroke in Asian countries and probably in India. Aim: The aim of this study was to describe the risk factors, distribution of vascular lesions, recurrence and outcome of stroke due to ICAS. Methodology: A total of 100 consecutive patients of ischemic stroke due to ICAS were enrolled prospectively from January 1, 2015, to December 31, 2015, and followed for 1 year for treatment compliance and recurrence...
October 2017: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/29128648/a-hypertension-emergency-department-intervention-aimed-at-decreasing-disparities-design-of-a-randomized-clinical-trial
#7
Heather M Prendergast, Marina Del Rios, Renee Petzel-Gimbar, Daniel Garside, Sara Heinert, Sandra Escobar-Schulz, Pavitra Kotini-Shah, Michael Brown, Jinsong Chen, Joseph Colla, Marian Fitzgibbon, Ramon A Durazo-Arvizu, Martha Daviglus
Effective interventions to identify and treat uncontrolled hypertension (HTN), particularly in underrepresented populations that use the emergency department (ED) for primary care, are critically needed. Uncontrolled HTN contributes significantly to cardiovascular morbidity and mortality and is more frequently encountered among patients presenting to the ED as compared to the primary care setting. EDs serve as the point of entry into the health care system for high-risk patient populations, including minority and low-income patients...
November 8, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/29061728/central-iliac-arteriovenous-anastomosis-for-uncontrolled-hypertension-one-year-results-from-the-rox-control-htn-trial
#8
RANDOMIZED CONTROLLED TRIAL
Melvin D Lobo, Christian Ott, Paul A Sobotka, Manish Saxena, Alice Stanton, John R Cockcroft, Neil Sulke, Eamon Dolan, Markus van der Giet, Joachim Hoyer, Stephen S Furniss, John P Foran, Adam Witkowski, Andrzej Januszewicz, Danny Schoors, Konstantinos Tsioufis, Benno J Rensing, Benjamin Scott, G André Ng, Roland E Schmieder
Creation of a central iliac arteriovenous anastomosis using a novel nitinol coupler device results in an immediate, significant reduction of blood pressure (BP). We present efficacy and safety findings at 12 months post-coupler insertion. This open-label, multicenter, prospective, randomized trial enrolled patients with a baseline office systolic BP ≥140 mm Hg and average daytime ambulatory BP ≥135/85 mm Hg. Subjects were randomly allocated to coupler implantation and continuing previous pharmacotherapy or to maintain previous treatment alone...
December 2017: Hypertension
https://www.readbyqxmd.com/read/29017994/utilizing-consumer-health-informatics-to-support-management-of-hypertension-by-clinical-pharmacists-in-primary-care-study-protocol
#9
Lorraine R Buis, Dana N Roberson, Reema Kadri, Nicole G Rockey, Melissa A Plegue, Hae Mi Choe, Caroline R Richardson
BACKGROUND: Hypertension (HTN) is a major public health concern in the United States given its wide prevalence, high cost, and poor rates of control. Multiple strategies to counter this growing epidemic have been studied, and home blood pressure (BP) monitoring, mobile health (mHealth) interventions, and referrals to clinical pharmacists for BP management have all shown potential to be effective intervention strategies. OBJECTIVE: The purpose of this study is to establish feasibility and acceptability of BPTrack, a clinical pharmacist-led mHealth intervention that aims to improve BP control by supporting home BP monitoring and medication adherence among patients with uncontrolled HTN...
October 10, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28959487/current-management-of-spontaneous-intracerebral-haemorrhage
#10
REVIEW
Cyrus K Dastur, Wengui Yu
Intracerebral haemorrhage (ICH) is the most devastating and disabling type of stroke. Uncontrolled hypertension (HTN) is the most common cause of spontaneous ICH. Recent advances in neuroimaging, organised stroke care, dedicated Neuro-ICUs, medical and surgical management have improved the management of ICH. Early airway protection, control of malignant HTN, urgent reversal of coagulopathy and surgical intervention may increase the chance of survival for patients with severe ICH. Intensive lowering of systolic blood pressure to <140 mm Hg is proven safe by two recent randomised trials...
March 2017: Stroke and Vascular Neurology
https://www.readbyqxmd.com/read/28930497/improving-blood-pressure-control-using-smart-technology
#11
Elizabeth L Ciemins, Anupama Arora, Nicholas C Coombs, Barbara Holloway, Elizabeth J Mullette, Robin Garland, Shannon Walsh Bishop-Green, Jerry Penso, Patricia J Coon
BACKGROUND: The authors sought to determine if wireless oscillometric home blood pressure monitoring (HBPM) that integrates with smartphone technology improves blood pressure (BP) control among patients with new or existing uncontrolled hypertension (HTN). METHODS: A prospective observational cohort study monitored BP control before and after an educational intervention and introduction to HBPM. Patients in the intervention group were instructed to track their BP using a smartphone device three to seven times per week...
September 30, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28859944/catheter-based-renal-denervation-in-patients-with-uncontrolled-hypertension-in-the-absence-of-antihypertensive-medications-spyral-htn-off-med-a-randomised-sham-controlled-proof-of-concept-trial
#12
Raymond R Townsend, Felix Mahfoud, David E Kandzari, Kazuomi Kario, Stuart Pocock, Michael A Weber, Sebastian Ewen, Konstantinos Tsioufis, Dimitrios Tousoulis, Andrew S P Sharp, Anthony F Watkinson, Roland E Schmieder, Axel Schmid, James W Choi, Cara East, Anthony Walton, Ingrid Hopper, Debbie L Cohen, Robert Wilensky, David P Lee, Adrian Ma, Chandan M Devireddy, Janice P Lea, Philipp C Lurz, Karl Fengler, Justin Davies, Neil Chapman, Sidney A Cohen, Vanessa DeBruin, Martin Fahy, Denise E Jones, Martin Rothman, Michael Böhm
BACKGROUND: Previous randomised renal denervation studies did not show consistent efficacy in reducing blood pressure. The objective of our study was to evaluate the effect of renal denervation on blood pressure in the absence of antihypertensive medications. METHODS: SPYRAL HTN-OFF MED was a multicentre, international, single-blind, randomised, sham-controlled, proof-of-concept trial. Patients were enrolled at 21 centres in the USA, Europe, Japan, and Australia...
November 11, 2017: Lancet
https://www.readbyqxmd.com/read/28605448/efficacy-of-peptide-receptor-radionuclide-therapy-for-functional-metastatic-paraganglioma-and-pheochromocytoma
#13
COMPARATIVE STUDY
Grace Kong, Simona Grozinsky-Glasberg, Michael S Hofman, Jason Callahan, Amichay Meirovitz, Ofra Maimon, David A Pattison, David J Gross, Rodney J Hicks
Purpose: Treatment options for unresectable paraganglioma (PGL)/pheochromocytoma (PCC), especially with uncontrolled secondary hypertension (HTN), are limited. Preliminary studies with peptide receptor radionuclide therapy (PRRT) suggest efficacy, but data on HTN control and survival are lacking. We assessed PRRT outcomes in such patients from two referral centers. Methods: Twenty consecutive patients (13 men; age range, 21 to 77 years) with high somatostatin receptor (SSTR) expression treated with 177Lu-DOTA-octreotate, nine with radiosensitizing chemotherapy, were retrospectively reviewed...
September 1, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28497091/restless-leg-syndrome-in-chronic-hemodialysis-patients-in-mashhad-hemodialysis-centers
#14
Niloufar Zadeh Saraji, Maryam Hami, Reza Boostani, Mohammad Javad Mojahedi
Introduction: Restless leg syndrome (RLS) is a sensory motor disorder. Patients with this syndrome have serious and uncontrollable desire to move their legs, which is mostly due to an uncomfortable feeling intensified when they are motionless. It may be a genetic disorder or secondary to iron deficiency, neurodegenerations, pregnancy, some drugs and severe kidney diseases. Objectives: This study was designed to find out the prevalence and its risk factors of RLS in hemodialysis patients. Patients and Methods: This multicenter cross-sectional study was done on 260 hemodialysis patients...
2017: Journal of Renal Injury Prevention
https://www.readbyqxmd.com/read/28482815/hypertension-in-cameroon-associated-with-high-likelihood-of-obstructive-sleep-apnea-a-pilot-study
#15
Alfred Kongnyu Njamnshi, Michel Karngong Mengnjo, Eta Ngole Mbong, Samuel Kingue, Julius Yundze Fonsah, Andreas Ateke Njoh, Leonard Njamnshi Nfor, Leonard Ngarka, Samuel Eric Chokote, Felicien Enyime Ntone
BACKGROUND: Although disordered sleep patterns predispose to hypertension (HTN), little is known on the effect of the latter on sleep patterns in sub-Saharan Africa. This study therefore sought to generate preliminary data on the likelihood (risk) of Obstructive sleep apnea (OSA) in hypertensive patients, with the aid of sleep questionnaires. METHODS: This case-control study, age-and-sex-matched HTN patients with normotensive participants, and compared sleep patterns in either group determined with the aid of the Berlin Questionnaire (BQ) and Epworth Sleepiness Scale (ESS)...
May 8, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28462714/renal-denervation-therapy-can-it-contribute-to-better-blood-pressure-control-in-hypertension
#16
Costas Tsioufis, Kyriakos Dimitriadis, Athanasios Kordalis, Michalis Doumas, Dimitris Konstantinidis, Theodoros Kalos, Felix Mahfoud, Vasilios Papademetriou, Dimitrios Tousoulis
Although the first results from studies suggested important benefits regarding blood pressure (BP) control in resistant hypertension by the use of diverse systems of renal denervation (RDN) in the setting of resistant hypertension, the Symplicity HTN-3, randomized sham-controlled trial reduced the enthusiasm and led to a more critical approach towards this neuromodulation innovative therapy. Nowadays there is an ongoing research attempt to justify the pathophysiological background of RDN since overdrive of the sympathetic nervous system is one of the key mechanisms leading to the development and progression of the hypertensive and cardiovascular diseases...
April 26, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28461828/from-clinical-considerations-to-theory-blood-pressure-variability-profiles-and-patterns
#17
Diana E Cretu, Cristina Japie, Emma Weiss, Magda Bunea, Sabina Frunza, Ana Maria Daraban, Daniela Bartos, Elisabeta Badila
BACKGROUND: Blood pressure variability (BPV) has recently been associated with adverse cardiovascular (CV) events, endothelial dysfunction as well as both CV and non-CV morbidity and mortality. Different BPV indicators have been associated with increased CV risk. METHODS: We included 744 hypertensive patients referred to our clinic for uncontrolled arterial hypertension (HTN) between 2012 and 2014, with a minimum of 40 successful daytime and 8 successful nighttime readings on automatic blood pressure monitoring (ABPM Meditech-05 device, recordings at 15-20 minutes intervals during daytime and 20-30 minutes intervals during nighttime)...
June 2016: Mædica
https://www.readbyqxmd.com/read/28451851/obesity-associated-hypertension-the-upcoming-phenotype-in-african-american-women
#18
REVIEW
Rohan Samson, Andrea Qi, Abhishek Jaiswal, Thierry H Le Jemtel, Suzanne Oparil
PURPOSE OF REVIEW: The present obesity epidemic particularly affects African-American women. Whether the obesity epidemic will alter the hypertension phenotype in African-American women is entertained. RECENT FINDINGS: The prevalence of morbid obesity is steadily increasing in African-American women, who are prone to developing hypertension (HTN) even in the absence of obesity. The obesity-associated hypertension phenotype is characterized by marked sympathetic nervous system activation and resistance/refractoriness to antihypertensive therapy...
May 2017: Current Hypertension Reports
https://www.readbyqxmd.com/read/28338871/renal-sympathetic-denervation-a-viable-option-for-treating-resistant-hypertension
#19
Markus P Schlaich
Accumulating evidence from mainly uncontrolled clinical studies with various types of ablation catheters have shown that renal denervation (RDN) can be applied safely and is effective in lowering blood pressure (BP) in patients with treatment-resistant hypertension. Sustained BP lowering has been documented up to 3 years. Furthermore, RDN has been associated with regression of target organ damage, such as left ventricular hypertrophy, arterial stiffness, and others. Several studies indicate potential benefit in other common clinical conditions associated with increased sympathetic tone including chronic kidney disease and heart failure...
September 1, 2017: American Journal of Hypertension
https://www.readbyqxmd.com/read/28282337/practice-level-costs-of-office-based-hypertension-performance-improvement-the-heart-healthy-lenoir-study
#20
(no author information available yet)
Primary care practice leaders who consider engaging in quality improvement (QI) need to understand the practice level costs incurred when asking staff to take on new tasks. The Heart Healthy Lenoir study is a prospective cohort trial in which QI methods were used to enhance hypertension (HTN) care and reduce racial disparities in blood pressure control in small rural primary care practices in North Carolina. As part of this effort, we performed an activity-based costing analysis to describe the costs incurred to develop, implement, and maintain key tasks...
March 2017: Journal of Healthcare Management / American College of Healthcare Executives
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