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Uncontrolled HTN

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https://www.readbyqxmd.com/read/28338871/renal-sympathetic-denervation-a-viable-option-for-treating-resistant-hypertension
#1
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...
March 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
#2
(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
https://www.readbyqxmd.com/read/28280305/adherence-to-recommended-lifestyle-modifications-and-factors-associated-for-hypertensive-patients-attending-chronic-follow-up-units-of-selected-public-hospitals-in-addis-ababa-ethiopia
#3
Abel Tibebu, Daniel Mengistu, Lemma Negesa
INTRODUCTION: One of the most prevalent noncommunicable diseases is hypertension (HTN). The availability of effective antihypertensive medications does not result in the expected outcomes in terms of controlling blood pressure. The rationale for these and other findings of uncontrolled HTN points toward poor adherence. The most neglected causes of uncontrolled HTN are unhealthy lifestyles. Few studies have been conducted to show the gap and magnitude of self-management adherence. OBJECTIVE: This study aimed to assess adherence to recommended lifestyle modifications of hypertensive patients undergoing follow-up at chronic follow-up units of public health hospitals in Addis Ababa, Ethiopia, 2016...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28148474/text-messaging-to-improve-hypertension-medication-adherence-in-african-americans-from-primary-care-and-emergency-department-settings-results-from-two-randomized-feasibility-studies
#4
Lorraine Buis, Lindsey Hirzel, Rachelle M Dawood, Katee L Dawood, Lauren P Nichols, Nancy T Artinian, Loren Schwiebert, Hossein N Yarandi, Dana N Roberson, Melissa A Plegue, LynnMarie C Mango, Phillip D Levy
BACKGROUND: Hypertension (HTN) is an important problem in the United States, with an estimated 78 million Americans aged 20 years and older suffering from this condition. Health disparities related to HTN are common in the United States, with African Americans suffering from greater prevalence of the condition than whites, as well as greater severity, earlier onset, and more complications. Medication adherence is an important component of HTN management, but adherence is often poor, and simply forgetting to take medications is often cited as a reason...
February 1, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/27922849/renal-denervation-for-uncontrolled-hypertension-critical-review-of-the-evidence
#5
Chongjia Chen, Ashish Upadhyay
PURPOSE OF REVIEW: Hypertension (HTN) is a major global public health problem. Endovascular catheter-based radiofrequency ablation of renal sympathetic nerve endings (renal denervation) is a novel treatment option for uncontrolled HTN. RECENT FINDINGS: Early clinical studies primarily in Australia and Europe established renal denervation as a well tolerated and feasible procedure that resulted in a sustained reduction in blood pressure among individuals with severe resistant HTN...
March 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/27892612/the-prevalence-of-depressive-symptoms-among-older-patients-with-hypertension-in-rural-china
#6
Jiang Xue, Shulin Chen, Hillary R Bogner, Wan Tang, Lydia Li, Yeates Conwell
OBJECTIVE: The comorbidity of depression and hypertension (HTN) is common and complicates the management of both conditions. This study investigated the prevalence of depressive symptoms among older patients with HTN in rural China and explored the relationship between the two conditions. METHODS: The baseline data of older patients diagnosed with HTN included in the depression/HTN in Chinese Older Adults-Collaborations for Health Study were used for the analysis...
November 28, 2016: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/27797437/screening-and-treatment-for-subclinical-hypertensive-heart-disease-in-emergency-department-patients-with-uncontrolled-blood-pressure-a-cost-effectiveness-analysis
#7
Michael J Twiner, Alexander L Marinica, Kenneth Kuper, Allen Goodman, James J Mahn, Michael J Burla, Aaron M Brody, Justin A Carroll, Robina Josiah Willock, John M Flack, Samar A Nasser, Phillip D Levy
OBJECTIVES: Poorly controlled hypertension (HTN) is extremely prevalent and, if left unchecked, subclinical hypertensive heart disease (SHHD) may ensue leading to conditions such as heart failure. To address this, we designed a multidisciplinary program to detect and treat SHHD in a high-risk, predominantly African American community. The primary objective of this study was to determine the cost-effectiveness of our program. METHODS: Study costs associated with identifying and treating patients with SHHD were calculated and a sensitivity analysis was performed comparing the effect of four parameters on cost estimates...
February 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27788856/regression-to-the-mean-in-symplicity%C3%A2-htn-3-implications-for-design-and-reporting-of-future-trials
#8
REVIEW
Stuart J Pocock, George Bakris, Deepak L Bhatt, Sandeep Brar, Martin Fahy, Bernard J Gersh
Regression to the mean (RTM) describes the tendency for an extreme measurement on 1 occasion to become less extreme when measured again. RTM may affect clinical trial data interpretation when the outcome measure has high variability. We investigated RTM in the SYMPLICITY HTN-3 (Renal Denervation in Patients With Uncontrolled Hypertension) trial of renal denervation versus a sham procedure. Analysis of covariance was performed on the 6-month change in systolic blood pressure, estimating a mean treatment difference of -4...
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27759337/management-practices-in-indian-patients-with-uncontrolled-hypertension
#9
Rajkumar Bharatia, Manoj Chitale, Ganesh Narain Saxena, Raman Ganesh Kumar, Chikkalingaiah, Abhijit Trailokya, Kalpesh Dalvi, Suhas Talele
INTRODUCTION: Hypertension (HTN), being a major risk factor for cardiovascular diseases (CVDs), is an important issue of medical and public health. High blood pressure (BP) is ranked as the third most important risk factor for attributable burden of disease in south Asia (2010). Hypertension (HTN) exerts a substantial public health burden on cardiovascular health status and healthcare systems in India. Uncontrolled hypertension among adults with hypertension is associated with increased mortality...
July 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27754274/sy-17-4-neuro-immune-communication-in-hypertension-a-new-therapeutic-angle
#10
Mohan Raizada
Hypertension (HTN) is the most prevalent modifiable risk for cardiovascular disease (CVD) and disorders directly influencing CVD (i.e. obesity, diabetes, chronic kidney disease, obstructive sleep apnea, etc.). About one billion people worldwide have HTN, with American adults having 90% lifetime risk of developing HTN. Despite aggressive campaign for lifestyle changes and advances in drug therapy, HTN remains an immense health, emotional, and economic challenge. This is due, in part, to the fact that ∼50% of HTN patients' blood pressure remains uncontrolled and ∼20% of HTN patients are resistant to or require > antihypertensive drugs...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27754181/db-03-1-renal-sympathetic-denervation-is-still-a-viable-option-for-treating-resistant-hypertension-pro
#11
Markus Schlaich
Accumulating evidence from mainly uncontrolled and unblinded 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 most patients with treatment resistant hypertension. Sustained BP lowering has been documented up to 3 years at this stage. 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 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27754072/os-18-04-hypertension-as-a-predictor-of-pattern-of-lv-hypertrophy-and-geometric-remodeling-in-elderly-happy-model-study
#12
Unna Triam-Anuruck, Prin Vathesatogkit, Teerapat Yingchoncharoen, Wisuit Katekao, Oraporn See, Sukit Yamwong, Piyamitr Sritara
OBJECTIVE: Hypertension (HTN) inarguably causes remodeling of left ventricle (LV). However, the effect of awareness, treatment and control of hypertension on LV geometry has not been established. We sought to identify the relationship between the classification of LV geometry and awareness, treatment and control of hypertension in a large Thai elderly population. DESIGN AND METHOD: Participants with complete echocardiographic data were enrolled in 2012. Detailed hypertension data was retrieved from the survey in 1997, 2002, 2007 and 2012...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27753860/me-01-2-assessment-and-treatment-of-morning-hypertension-update
#13
Kazuomi Kario
The essential benefit of the management of hypertension is derived from the blood pressure (BP) lowering per se, indicating the importance of BP throughout 24 hours. Recent guidelines stressed the importance of home BP for the diagnosis and management of hypertension. It is well-known that cardiovascular events occur more frequently in the morning BP levels have been shown to increase during the period from night to early morning. Clinical research using ambulatory BP monitoring (ABPM) or home BP monitoring has clarified that morning BP and BP surge are more closely related to the cardiovascular risk than office BP (Kario et al...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27677856/survey-of-emergency-physician-approaches-to-management-of-asymptomatic-hypertension
#14
Aaron Brody, Michael Twiner, Arun Kumar, Elizabeth Goldberg, Candace McNaughton, Kimberly Souffront, Scott Millis, Phillip D Levy
Uncontrolled hypertension (HTN) is commonly encountered in emergency medicine practice, but the optimal approach to management has not been delineated. The objective of this study was to define emergency physician (EP) approaches to management of asymptomatic HTN in various clinical scenarios and assess adherence to the American College of Emergency Physician clinical policies, utilizing an online survey of EPs. A total of 1200 surveys were distributed by e-mail with completion by 199 participants. The variables associated with a decision to prescribe oral antihypertensive medications were a history of HTN and referral from primary care...
March 2017: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/27643271/sy-17-4-neuro-immune-communication-in-hypertension-a-new-therapeutic-angle
#15
Mohan Raizada
Hypertension (HTN) is the most prevalent modifiable risk for cardiovascular disease (CVD) and disorders directly influencing CVD (i.e. obesity, diabetes, chronic kidney disease, obstructive sleep apnea, etc.). About one billion people worldwide have HTN, with American adults having 90% lifetime risk of developing HTN. Despite aggressive campaign for lifestyle changes and advances in drug therapy, HTN remains an immense health, emotional, and economic challenge. This is due, in part, to the fact that ∼50% of HTN patients' blood pressure remains uncontrolled and ∼20% of HTN patients are resistant to or require > antihypertensive drugs...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27643138/db-03-1-renal-sympathetic-denervation-is-still-a-viable-option-for-treating-resistant-hypertension-pro
#16
Markus Schlaich
Accumulating evidence from mainly uncontrolled and unblinded 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 most patients with treatment resistant hypertension. Sustained BP lowering has been documented up to 3 years at this stage. 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 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27643097/me-01-2-assessment-and-treatment-of-morning-hypertension-update
#17
Kazuomi Kario
The essential benefit of the management of hypertension is derived from the blood pressure (BP) lowering per se, indicating the importance of BP throughout 24 hours. Recent guidelines stressed the importance of home BP for the diagnosis and management of hypertension. It is well-known that cardiovascular events occur more frequently in the morning BP levels have been shown to increase during the period from night to early morning. Clinical research using ambulatory BP monitoring (ABPM) or home BP monitoring has clarified that morning BP and BP surge are more closely related to the cardiovascular risk than office BP (Kario et al...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27642993/os-18-04-hypertension-as-a-predictor-of-pattern-of-lv-hypertrophy-and-geometric-remodeling-in-elderly-happy-model-study
#18
Unna Triam-Anuruck, Prin Vathesatogkit, Teerapat Yingchoncharoen, Wisuit Katekao, Oraporn See, Sukit Yamwong, Piyamitr Sritara
OBJECTIVE: Hypertension (HTN) inarguably causes remodeling of left ventricle (LV). However, the effect of awareness, treatment and control of hypertension on LV geometry has not been established. We sought to identify the relationship between the classification of LV geometry and awareness, treatment and control of hypertension in a large Thai elderly population. DESIGN AND METHOD: Participants with complete echocardiographic data were enrolled in 2012. Detailed hypertension data was retrieved from the survey in 1997, 2002, 2007 and 2012...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27508800/-op-lb-02-04-central-iliac-arteriovenous-anastomosis-for-uncontrolled-hypertension-12-month-follow-up-results-of-the-rox-control-htn-randomised-controlled-trial
#19
M Lobo, M Saxena, P A Sobotka, C Ott, E Dolan, J Foran, S S Furniss, J Cockcroft, M Van Der Giet, J Hoyer, A Januszewicz, G A Ng, B Rensing, B Scott, D Schoors, A Stanton, N Sulke, C Tsioufis, A Witkowski, R E Schmieder
OBJECTIVE: Creation of a central iliac arteriovenous (AV) 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, extending the initial 6 month primary endpoint report (Lancet 2015). DESIGN AND METHOD: This open-label, multicentre, prospective, randomised trial, enrolled patients with a baseline office systolic blood pressure (SBP) >140 mmHg, average daytime ambulatory SBP > 135 mmHg, and ambulatory diastolic blood pressure (DBP) > 85 mmHg...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27469372/reduced-blood-pressure-lowering-effect-of-catheter-based-renal-denervation-in-patients-with-isolated-systolic-hypertension-data-from-symplicity-htn-3-and-the-global-symplicity-registry
#20
Felix Mahfoud, George Bakris, Deepak L Bhatt, Murray Esler, Sebastian Ewen, Martin Fahy, David Kandzari, Kazuomi Kario, Giuseppe Mancia, Michael Weber, Michael Böhm
AIMS: Catheter-based renal artery denervation (RDN) has been shown to lower blood pressure (BP) in certain patients with uncontrolled hypertension. Isolated systolic hypertension (ISH) (systolic BP [SBP] ≥140 mmHg and diastolic BP <90 mmHg), characterized by increased vascular stiffness, is the predominant hypertensive phenotype in elderly patients. This study compared baseline characteristics and SBP change at 6 months between patients with ISH and combined systolic-diastolic hypertension (CH)...
July 28, 2016: European Heart Journal
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