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Uncontrolled HTN

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https://www.readbyqxmd.com/read/27892612/the-prevalence-of-depressive-symptoms-among-older-patients-with-hypertension-in-rural-china
#1
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
#2
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 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 (HF). 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...
October 31, 2016: 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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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...
September 28, 2016: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/27643271/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/27643138/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/27643097/me-01-2-assessment-and-treatment-of-morning-hypertension-update
#12
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
#13
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
#14
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
#15
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
https://www.readbyqxmd.com/read/27461397/prevalence-of-electrocardiographic-abnormalities-based-on-hypertension-severity-and-blood-pressure-levels-the-reasons-for-geographic-and-racial-differences-in-stroke-study
#16
Hemal Bhatt, Christopher M Gamboa, Monika M Safford, Elsayed Z Soliman, Stephen P Glasser
We evaluated the prevalence of major and minor electrocardiographic (ECG) abnormalities based on blood pressure (BP) control and hypertension (HTN) treatment resistance. We analyzed data from the Reasons for Geographic and Racial Differences in Stroke study of 20,932 participants who were divided into presence of major (n = 3782), only minor (n = 8944), or no (n = 8206) ECG abnormalities. The cohort was stratified into normotension (n = 3373), pre-HTN (n = 4142), controlled HTN (n = 8619), uncontrolled HTN (n = 3544), controlled apparent treatment-resistant HTN (aTRH, n = 400), and uncontrolled aTRH (n = 854) groups, and the prevalence ratios (PRs) of major and minor ECG abnormalities were assessed separately for each BP group...
September 2016: Journal of the American Society of Hypertension: JASH
https://www.readbyqxmd.com/read/27440977/reaching-for-health-equity-and-social-justice-in-baltimore-the-evolution-of-an-academic-community-partnership-and-conceptual-framework-to-address-hypertension-disparities
#17
Lisa A Cooper, Tanjala S Purnell, Chidinma A Ibe, Jennifer P Halbert, Lee R Bone, Kathryn A Carson, Debra Hickman, Michelle Simmons, Ann Vachon, Inez Robb, Michelle Martin-Daniels, Katherine B Dietz, Sherita Hill Golden, Deidra C Crews, Felicia Hill-Briggs, Jill A Marsteller, L Ebony Boulware, Edgar R Iii Miller, David M Levine
Cardiovascular health disparities persist despite decades of recognition and the availability of evidence-based clinical and public health interventions. Racial and ethnic minorities and adults in urban and low-income communities are high-risk groups for uncontrolled hypertension (HTN), a major contributor to cardiovascular health disparities, in part due to inequitable social structures and economic systems that negatively impact daily environments and risk behaviors. This commentary presents the Johns Hopkins Center to Eliminate Cardiovascular Health Disparities as a case study for highlighting the evolution of an academic-community partnership to overcome HTN disparities...
2016: Ethnicity & Disease
https://www.readbyqxmd.com/read/27363822/a-substudy-evaluating-treatment-intensification-on-medication-adherence-among-hypertensive-patients-receiving-home-blood-pressure-telemonitoring-and-pharmacist-management
#18
P A Pawloski, S E Asche, N K Trower, A R Bergdall, S P Dehmer, M V Maciosek, R A Nyboer, P J O'Connor, J M Sperl-Hillen, B B Green, K L Margolis
WHAT IS KNOWN AND OBJECTIVE: Hypertension is a leading cause of death and major contributor to heart attacks, strokes, heart and kidney failure. Antihypertensive (HTN medication) non-adherence contributes to uncontrolled hypertension. Effective initiatives to improve uncontrolled hypertension include a team-based approach with home blood pressure (BP) monitoring. Our study objective was to evaluate whether objectively measured medication adherence was influenced by home BP telemonitoring and pharmacist management...
October 2016: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/27324843/is-there-an-association-between-the-prevalence-of-atrial-fibrillation-and-severity-and-control-of-hypertension-the-reasons-for-geographic-and-racial-differences-in-stroke-study
#19
Hemal Bhatt, Christopher M Gamboa, Monika M Safford, Elsayad Z Soliman, Stephen P Glasser
The association of atrial fibrillation (AF) with the severity and control of hypertension (HTN) remains unclear. We analyzed data from the national biracial cohort of REasons for Geographic And Racial Differences in Stroke study. The AF prevalence ratios were estimated and full multivariable adjustment included demographics, risk factors, medication adherence, HTN duration, and antihypertensive medication classes. Of the 30,018 study participants (8.6% with AF), 4386 had normotension (4.3% with AF), 5916 had prehypertension (4...
July 2016: Journal of the American Society of Hypertension: JASH
https://www.readbyqxmd.com/read/27311520/level-of-blood-pressure-control-and%C3%A2-cardiovascular-events-sprint-criteria-versus-the-2014-hypertension-recommendations
#20
Min Jung Ko, Ae Jung Jo, Chan Mi Park, Hyo Jeong Kim, Yun Jung Kim, Duk-Woo Park
BACKGROUND: Blood pressure (BP) targets from the SPRINT (Systolic Blood Pressure Intervention Trial) differ from targets of the 2014 hypertension (HTN) recommendations of the Eighth Joint National Committee. OBJECTIVES: The goal of this study was to estimate the proportion of hypertensive adults with who would meet BP goals under the SPRINT criteria and under the 2014 recommendations, and to determine related effects on cardiovascular morbidity and mortality. METHODS: We used data from the Korean National Health and Nutrition Examination Survey of 2008 to 2013 (n = 13,346), as well as the Korean National Health Insurance Service health examinee cohort of 2007 (n = 67,965), to estimate the proportion of subjects meeting BP goals of each of the criteria...
June 21, 2016: Journal of the American College of Cardiology
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