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Practice guidelines for essential hypertension

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https://www.readbyqxmd.com/read/28968870/patient-characteristics-do-not-predict-the-individual-response-to-antihypertensive-medication-a-cross-over-trial
#1
Mark C van der Wel, Marion Biermans, Reinier Akkermans, Jacques W M Lenders, Chris van Weel, Jaap Deinum
Background: International guidelines on hypertension management do not agree on whether patient characteristics can be used for the first choice of treatment of uncomplicated essential hypertension. Objective: We wanted to identify predictive patient characteristics to the response of two different classes of antihypertensive drugs in patients with newly diagnosed hypertension in primary care. Methods: We conducted a prospective, open label, blinded endpoint cross-over trial in 120 patients with a new diagnosis of hypertension from 10 family practices...
August 31, 2017: Family Practice
https://www.readbyqxmd.com/read/28816547/drug-utilization-among-hypertensive-patients-in-the-outpatient-department-of-medicine-in-a-tertiary-care-hospital-a-cross-sectional-study
#2
Sarika G Paradkar, Shyamal R Sinha
BACKGROUND: Hypertension is one of the leading risk factors for cardiovascular, cerebrovascular, and renal disease. Its increasing prevalence and treatment costs influence the prescribing pattern among physicians. Drug utilization studies provide insights into the current prescribing practices and help us facilitate the rational use of drugs. We carried out the present study to assess the pattern of drug utilization in hypertensive patients. METHOD: Adults seeking treatment for hypertension were recruited...
August 17, 2017: Clinical and Experimental Hypertension: CHE
https://www.readbyqxmd.com/read/28756578/design-and-application-of-a-medication-assessment-tool-for-secondary-prevention-of-stroke
#3
Marise Gauci, Francesca Wirth, Liberato Camilleri, Lilian M Azzopardi, Anthony Serracino-Inglott
Background Optimisation of drug therapy is essential in the care of older persons and may be facilitated by application of medication assessment tools (MATs). Objective To design, psychometrically evaluate and apply an innovative MAT for secondary prevention of ischaemic stroke with particular relevance to older persons. Method Review criteria were selected from clinical practice guidelines and MAT-CVA was developed, validated and tested for reliability and feasibility. MAT-CVA was applied to 150 patients with a diagnosis of ischaemic stroke or transient ischaemic attack admitted to a rehabilitation hospital...
July 29, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28756383/relationship-between-initial-therapy-and-blood-pressure-control-for-high-risk-hypertension-patients-in-the-uk-a-retrospective-cohort-study-from-the-thin-general-practice-database
#4
Sharada Weir, Attila Juhasz, Jorge Puelles, Travis S Tierney
OBJECTIVE: To examine the UK practice patterns in treating newly diagnosed hypertension and to determine whether subgroups of high-risk patients are more or less likely to follow particular therapeutic protocols and to reach blood pressure goals. DESIGN: Retrospective cohort study. SETTING: This study examined adults in The Health Improvement Network (THIN) UK general practice medical records database who were initiated on medication for hypertension...
July 28, 2017: BMJ Open
https://www.readbyqxmd.com/read/28397445/-from-right-to-left-the-role-of-right-heart-catheterization-in-the-diagnosis-and-management-of-left-heart-diseases
#5
REVIEW
Marta Kałużna-Oleksy, Aleksander Araszkiewicz, Jacek Migaj, Maciej Lesiak, Ewa Straburzyńska-Migaj
Pulmonary hypertension (PH), second only to left heart diseases (LHD), is a frequent problem in clinical practice. At the same time, left heart diseases represent the most common cause of pulmonary hypertension, and the occurrence of PH in patients with chronic heart failure is usually associated with worse functional class, and prognosis. Right heart catheterization (RHC) is the "gold standard" in the diagnosis and differentiation of PH. It is also essential in the process of qualifying for a heart transplantation...
January 2017: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/28365180/practices-in-management-of-cancer-treatment-related-cardiovascular-toxicity-a-cardio-oncology-survey
#6
Ludovic Jovenaux, Jennifer Cautela, Noemie Resseguier, Michele Pibarot, Myriam Taouqi, Morgane Orabona, Johan Pinto, Michael Peyrol, Jeremie Barraud, Marc Laine, Laurent Bonello, Franck Paganelli, Fabrice Barlesi, Franck Thuny
BACKGROUND: Cardiovascular toxicity has become a challenging issue during cancer therapy. Nonetheless, there is a lack of consensual guidelines for their management. We aimed to determine the current practices of oncologists regarding cardiovascular toxicity related to anthracyclines, trastuzumab and angiogenic inhibitors and to gather their opinions on the development of cardio-oncology programs. METHODS: A cross-sectional declarative study was submitted to French oncologists in the form of an individual, structured questionnaire...
March 21, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28050656/the-recommendations-of-a-consensus-panel-for-the-screening-diagnosis-and-treatment-of-neurogenic-orthostatic-hypotension-and-associated-supine-hypertension
#7
REVIEW
Christopher H Gibbons, Peter Schmidt, Italo Biaggioni, Camille Frazier-Mills, Roy Freeman, Stuart Isaacson, Beverly Karabin, Louis Kuritzky, Mark Lew, Phillip Low, Ali Mehdirad, Satish R Raj, Steven Vernino, Horacio Kaufmann
Neurogenic orthostatic hypotension (nOH) is common in patients with neurodegenerative disorders such as Parkinson's disease, multiple system atrophy, pure autonomic failure, dementia with Lewy bodies, and peripheral neuropathies including amyloid or diabetic neuropathy. Due to the frequency of nOH in the aging population, clinicians need to be well informed about its diagnosis and management. To date, studies of nOH have used different outcome measures and various methods of diagnosis, thereby preventing the generation of evidence-based guidelines to direct clinicians towards 'best practices' when treating patients with nOH and associated supine hypertension...
August 2017: Journal of Neurology
https://www.readbyqxmd.com/read/27974526/chronotherapy-for-hypertension-in-obstructive-sleep-apnoea-chosa-a-randomised-double-blind-placebo-controlled-crossover-trial
#8
RANDOMIZED CONTROLLED TRIAL
Yasmina Serinel, Brendon J Yee, Ronald R Grunstein, Keith H Wong, Peter A Cistulli, Hisatomi Arima, Craig L Phillips
BACKGROUND: Obstructive sleep apnoea (OSA) is an important cause of secondary hypertension. Nocturnal hypertension is particularly prevalent in OSA and is a strong predictor of cardiovascular mortality. Studies in patients with essential hypertension have suggested that nocturnal administration of antihypertensives improves nocturnal blood pressure (BP) without elevating daytime BP. We evaluated the efficacy of this technique in patients with OSA with stage I/II hypertension, both before and after the addition of CPAP...
June 2017: Thorax
https://www.readbyqxmd.com/read/27825176/-pulmonary-hypertension-cologne-consensus-conference-2016
#9
REVIEW
Stephan Rosenkranz, Hossein Ardeschir Ghofrani, Ekkehard Grünig, Hans Klose, Horst Olschewski, Christian Opitz, Marius Hoeper
Recently, the updated European Guidelines on the Diagnosis and Treatment of Pulmonary Hypertension (PH) have been published. The practical implementation of the guidelines considering country-specific aspects, current data and individual features is essential for clinical patient care. In order to accomplish this, in June 2016 the 2(nd) Cologne Consensus Conference organized by the PH working groups of the German Society of Cardiology (DGK), the German Society of Respiratory Medicine (DGP) and the German Society of Pediatric Cardiology (DGPK) was held in Cologne, Germany...
November 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27815929/challenges-in-the-management-of-hypertension-in-older-populations
#10
Lisa Pont, Tariq Alhawassi
The prevalence of hypertension increases with age making it a significant health concern for older persons. Aging involves a range of physiological changes such as increases in arterial stiffness, widening pulse pressure, changes in renin and aldosterone levels, decreases in renal salt excretion, declining in renal function, changes in the autonomic nervous system sensitivity and function and changes to endothelial function all of which may not only affect blood pressure but may also affect individual response to pharmacotherapy used to manage hypertension and prevent end organ damage and other complications associated with poor blood pressure control...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27760444/-pathobiology-pathology-and-genetics-of-pulmonary-hypertension-recommendations-of-the-cologne-consensus-conference-2016
#11
A Olschewski, E M Berghausen, C A Eichstaedt, B K Fleischmann, E Grünig, G Grünig, G Hansmann, L Harbaum, J K Hennigs, D Jonigk, W M Kübler, G Kwapiszewska, S S Pullamsetti, E Stacher, N Weissmann, D Wenzel, R T Schermuly
The 2015 European Guidelines on Diagnosis and Treatment of Pulmonary Hypertension (PH) are also valid for Germany. While the guidelines contain detailed recommendations regarding clinical aspects of pulmonary arterial hypertension (PAH) and other forms of PH, they contain only a relatively short paragraph on novel findings on the pathobiology, pathology, and genetics. However, these are of great importance for our understanding of this complex disease both from a clinical and scientific point of view, and they are essential for the development of novel treatment strategies...
October 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27754160/pl-03-1-hypertension-management-in-the-era-of-digital-information-and-communication-technologies
#12
Steven Steinhubl
Despite having the basic tools necessary to appropriately identify and manage individuals with hypertension for over half a century it remains the single greatest contributing risk factor to morbidity and mortality worldwide today. Since diagnosis and effective treatment availability are not issues, this major failing in care can be attributed to inadequate systems of care: systems that have led to only <20% of hypertensive individuals globally having their blood pressure adequately controlled. Even in the US, where it is one of the most common reasons for a primary care visit, and with over $42...
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/27753823/sy-01-1-adaptation-of-major-guidelines-for-regional-applications
#14
Ernesto Schiffrin
Clinical practice guidelines, which are systematically developed statements aimed at helping people make clinical, policy-related and system-related decisions, frequently vary widely in quality. A strategy is needed to differentiate among guidelines and ensure that those of the highest quality are implemented. Hypertension Canada provides annually updated standardized recommendations and clinical practice guidelines to detect, treat and control hypertension. The annual, evidence-based recommendations are developed through intense discussion of the clinical implications via a systematic review of the literature followed by critical appraisals of all the new clinical research, taking into account the assessment criteria in the Appraisal of Guidelines for Research & Evaluation (AGREE) II instrument that evaluates the process of practice guideline development and the quality of reporting...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27719677/community-health-workers-knowledge-and-practice-in-relation-to-pre-eclampsia-in-ogun-state-nigeria-an-essential-bridge-to-maternal-survival
#15
RANDOMIZED CONTROLLED TRIAL
J O Sotunsa, M Vidler, D O Akeju, M O Osiberu, E O Orenuga, O T Oladapo, R Qureshi, D Sawchuck, O O Adetoro, P von Dadelszen, O A Dada
BACKGROUND: Pre-eclampsia is a leading cause of maternal and fetal morbidity and mortality worldwide. Early detection and treatment have been instrumental in reducing case fatality in high-income countries. To achieve this in a low-income country, like Nigeria, community health workers who man primary health centres must have adequate knowledge and skills to identify and provide emergency care for women with pre-eclampsia. This study aimed to determine community health workers' knowledge and practice in the identification and treatment of pre-eclampsia, as they are essential providers of maternal care services in Nigeria...
September 30, 2016: Reproductive Health
https://www.readbyqxmd.com/read/27643115/pl-03-1-hypertension-management-in-the-era-of-digital-information-and-communication-technologies
#16
Steven Steinhubl
Despite having the basic tools necessary to appropriately identify and manage individuals with hypertension for over half a century it remains the single greatest contributing risk factor to morbidity and mortality worldwide today. Since diagnosis and effective treatment availability are not issues, this major failing in care can be attributed to inadequate systems of care: systems that have led to only <20% of hypertensive individuals globally having their blood pressure adequately controlled. Even in the US, where it is one of the most common reasons for a primary care visit, and with over $42...
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/27642876/sy-01-1-adaptation-of-major-guidelines-for-regional-applications
#18
Ernesto Schiffrin
Clinical practice guidelines, which are systematically developed statements aimed at helping people make clinical, policy-related and system-related decisions, frequently vary widely in quality. A strategy is needed to differentiate among guidelines and ensure that those of the highest quality are implemented. Hypertension Canada provides annually updated standardized recommendations and clinical practice guidelines to detect, treat and control hypertension. The annual, evidence-based recommendations are developed through intense discussion of the clinical implications via a systematic review of the literature followed by critical appraisals of all the new clinical research, taking into account the assessment criteria in the Appraisal of Guidelines for Research & Evaluation (AGREE) II instrument that evaluates the process of practice guideline development and the quality of reporting...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27520602/becoming-baby-friendly-and-transforming-maternity-care-in-a-safety-net-hospital-on-the-texas-mexico-border
#19
Deborah J Eganhouse, Leticia Gutierrez, Lorena Cuellar, Cecilia Velasquez
Nurse leaders used the Centers for Disease Control and Prevention's survey on Maternity Practices in Infant Nutrition and Care, as well as Baby-Friendly Hospital Initiative guidelines, to transform maternity care in a safety-net hospital with more than 3,500 births annually. Implementing evidence-based guidelines to support breastfeeding was essential for a vulnerable population characterized by minimal prenatal care and high rates of diabetes, hypertension, obesity, and poverty. Research showing the importance of breastfeeding in protecting against these factors guided extensive changes in our maternity care model...
August 2016: Nursing for Women's Health
https://www.readbyqxmd.com/read/27511382/gestational-diabetes-mellitus-an-evaluation-of-gynecologists-knowledge-of-guidelines-and-counseling-behavior
#20
Sophie Schmitz, Tanja Groten, Ekkehard Schleussner, Wilgard Battefeld, Peter Hillemanns, Cordula Schippert, Frauke von Versen-Höynck
PURPOSE: Knowledge of risks, adequate pre- and post-partum care, and counseling is essential to reduce short- and long-term consequences for women with gestational diabetes mellitus (GDM) and their offspring. Our study explored the current GDM guideline knowledge and practiced patient counseling of private gynecologists in Germany. METHODS: A survey assessing the GDM guidelines and patient counseling was mailed to 775 practicing gynecologists. We evaluated the knowledge of maternal and offspring disease risks, counseling practice, and guideline awareness...
November 2016: Archives of Gynecology and Obstetrics
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