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https://www.readbyqxmd.com/read/28511070/impact-of-exaggerated-blood-pressure-response-in-normotensive-individuals-on-future-hypertension-and-prognosis-systematic-review-according-to-prisma-guideline
#1
REVIEW
Karsten Keller, Kathrin Stelzer, Mir Abolfazl Ostad, Felix Post
PURPOSE: Arterial hypertension (aHT) is the leading risk factor for morbidity and mortality worldwide. Blood pressure (BP) deviation at rest is well defined and accompanies risk for cardiovascular events and cardiovascular mortality. A growing body of evidence emphasises that an exaggerated blood pressure response (EBPR) in cardiopulmonary exercise testing (CPET) could help to identify seemingly cardiovascular healthy and normotensive subjects, who have an increased risk of developing aHT and cardiovascular events in the future...
May 13, 2017: Advances in Medical Sciences
https://www.readbyqxmd.com/read/28492286/has-the-sprint-trial-introduced-a-new-blood-pressure-goal-in-hypertension
#2
REVIEW
Gema Ruiz-Hurtado, José R Banegas, Pantelis A Sarafidis, Massimo Volpe, Bryan Williams, Luis M Ruilope
SPRINT is the first randomized, controlled trial showing that a systolic blood-pressure goal of <120 mmHg can be attained with cardiovascular benefits in a select group of patients with hypertension and an elevated cardiovascular risk with different origins. Although the patient population with characteristics like those in SPRINT makes up only 20-30% of the total hypertensive population, SPRINT is a landmark study that highlights the need to consider lower blood- pressure goals in the treatment of hypertension...
May 11, 2017: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/28481608/risk-factors-for-diabetic-retinopathy-among-homeless-veterans
#3
John A Davis, Irena Tsui, Lillian Gelberg, Sonya Gabrielian, Martin L Lee, Evelyn T Chang
Homeless patients have high rates of visual impairment and lower rates of glycemic control than housed patients. Although diabetic retinopathy (DR) is the most common cause of new visual impairment and legal blindness in the developed world, little is known about differential risk factors for and rates of DR in homeless versus housed populations. This study aimed to compare the rates of DR between homeless and housed patients with diabetes at the Greater Los Angeles Veterans Affairs Health care System (GLA) and identify clinical and psychosocial predictors of DR rates...
May 2017: Psychological Services
https://www.readbyqxmd.com/read/28475386/achieving-blood-pressure-targets-for-prolonged-cardiovascular-health-a-historical-perspective
#4
Steven G Chrysant
Hypertension is a major risk factor for coronary artery disease (CAD), stroke, heart failure, and chronic kidney disease (CKD), and its successful control leads to a decrease or prevention of these complications. Areas covered: Over the years the Joint National Committees and the American Heart Association have issued guidelines regarding the treatment of hypertension. Those of 2003 and 2007 respectively, have recommended reduction of blood pressure (BP) to < 140/90 mmHg for uncomplicated hypertension and to < 130/80 mmHg for hypertensive patients with diabetes mellitus, CKD, or CAD...
May 5, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28451445/who-are-patients-classified-within-the-new-terminology-of-heart-failure-from-the-2016-esc-guidelines
#5
Benoit Delepaul, Guillaume Robin, Clément Delmas, Thomas Moine, Adrien Blanc, Pauline Fournier, Aénora Roger-Rollé, Guillaume Domain, Clémence Delon, Charles Uzan, Rabah Boudjellil, Didier Carrié, Jérôme Roncalli, Michel Galinier, Olivier Lairez
AIMS: The main terminology used to describe heart failure (HF) is based on measurement of the left ventricular ejection fraction (LVEF). LVEF in the range of 40-49% was recently defined as HF with mid-range EF (HFmrEF) by the 2016 European Society of Cardiology guidelines. The purpose of our study was to assess the clinical profile and prognosis of patients with HF according to this new classification. METHODS AND RESULTS: A total of 482 patients referred for HF were retrospectively included over a period of 1 year...
May 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/28449829/hypertension-canada-s-2017-guidelines-for-the-diagnosis-%C3%A2-assessment-prevention-and-treatment-of%C3%A2-pediatric-hypertension
#6
Janis M Dionne, Kevin C Harris, Geneviève Benoit, Janusz Feber, Luc Poirier, Lyne Cloutier, Meranda Nakhla, Doreen M Rabi, Stella S Daskalopoulou, Anne Fournier
After the 2016 guidelines for blood pressure measurement, diagnosis, and investigation of pediatric hypertension, we now present evidence-based guidelines for the prevention and treatment of hypertension in children. These guidelines were developed by Hypertension Canada's Guideline Committee pediatric subgroup after thorough evaluation of the available literature. Included are 10 guidelines specifically addressing health behaviour management, indications for drug therapy in children with hypertension, choice of therapy for children with primary hypertension, and goals of therapy for children with hypertension...
May 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28449828/hypertension-canada-s-2017-guidelines-for-diagnosis-risk-assessment-prevention-and-treatment-of-hypertension-in-adults
#7
Alexander A Leung, Stella S Daskalopoulou, Kaberi Dasgupta, Kerry McBrien, Sonia Butalia, Kelly B Zarnke, Kara Nerenberg, Kevin C Harris, Meranda Nakhla, Lyne Cloutier, Mark Gelfer, Maxime Lamarre-Cliche, Alain Milot, Peter Bolli, Guy Tremblay, Donna McLean, Sheldon W Tobe, Marcel Ruzicka, Kevin D Burns, Michel Vallée, G V Ramesh Prasad, Steven E Gryn, Ross D Feldman, Peter Selby, Andrew Pipe, Ernesto L Schiffrin, Philip A McFarlane, Paul Oh, Robert A Hegele, Milan Khara, Thomas W Wilson, S Brian Penner, Ellen Burgess, Praveena Sivapalan, Robert J Herman, Simon L Bacon, Simon W Rabkin, Richard E Gilbert, Tavis S Campbell, Steven Grover, George Honos, Patrice Lindsay, Michael D Hill, Shelagh B Coutts, Gord Gubitz, Norman R C Campbell, Gordon W Moe, Jonathan G Howlett, Jean-Martin Boulanger, Ally Prebtani, Gregory Kline, Lawrence A Leiter, Charlotte Jones, Anne-Marie Côté, Vincent Woo, Janusz Kaczorowski, Luc Trudeau, Ross T Tsuyuki, Swapnil Hiremath, Denis Drouin, Kim L Lavoie, Pavel Hamet, Jean C Grégoire, Richard Lewanczuk, George K Dresser, Mukul Sharma, Debra Reid, Scott A Lear, Gregory Moullec, Milan Gupta, Laura A Magee, Alexander G Logan, Janis Dionne, Anne Fournier, Geneviève Benoit, Janusz Feber, Luc Poirier, Raj S Padwal, Doreen M Rabi
Hypertension Canada provides annually updated, evidence-based guidelines for the diagnosis, assessment, prevention, and treatment of hypertension. This year, we introduce 10 new guidelines. Three previous guidelines have been revised and 5 have been removed. Previous age and frailty distinctions have been removed as considerations for when to initiate antihypertensive therapy. In the presence of macrovascular target organ damage, or in those with independent cardiovascular risk factors, antihypertensive therapy should be considered for all individuals with elevated average systolic nonautomated office blood pressure (non-AOBP) readings ≥ 140 mm Hg...
May 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28431590/delays-in-door-to-needle-time-for-acute-ischemic-stroke-in-the-emergency-department-a-comprehensive-stroke-center-experience
#8
Ashkan Mowla, Jordan Doyle, Navdeep S Lail, Hamidreza Rajabzadeh-Oghaz, Christopher Deline, Peyman Shirani, Marilou Ching, Annemarie Crumlish, Deborah A Steck, David Janicke, Elad I Levy, Robert N Sawyer
BACKGROUND: Current American Stroke Association guidelines recommend initiating intravenous thrombolysis (IVT) for acute ischemic stroke (AIS) within 60min of patient arrival, given the benefits of IVT for AIS are time dependent. This study aimed to identify the delaying factors in door-to-needle time (DTN) in the emergency department of one of the largest comprehensive stroke centers in New York State. We also recommended measures to reduce the delays. METHODS: We retrospectively reviewed the medical charts of all AIS patients who received IVT in our emergency department patients between April 1, 2012 and December 31, 2015 to identify those with a DTN time of >60min...
May 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28427345/variation-in-gp-decisions-on-antihypertensive-treatment-in-oldest-old-and-frail-individuals-across-29-countries
#9
Sven Streit, Marjolein Verschoor, Nicolas Rodondi, Daiana Bonfim, Robert A Burman, Claire Collins, Gerasimovska Kitanovska Biljana, Sandra Gintere, Raquel Gómez Bravo, Kathryn Hoffmann, Claudia Iftode, Kasper L Johansen, Ngaire Kerse, Tuomas H Koskela, Sanda Kreitmayer Peštić, Donata Kurpas, Christian D Mallen, Hubert Maisoneuve, Christoph Merlo, Yolanda Mueller, Christiane Muth, Marija Petek Šter, Ferdinando Petrazzuoli, Thomas Rosemann, Martin Sattler, Zuzana Švadlenková, Athina Tatsioni, Hans Thulesius, Victoria Tkachenko, Peter Torzsa, Rosy Tsopra, Tuz Canan, Rita P A Viegas, Shlomo Vinker, Margot W M de Waal, Andreas Zeller, Jacobijn Gussekloo, Rosalinde K E Poortvliet
BACKGROUND: In oldest-old patients (>80), few trials showed efficacy of treating hypertension and they included mostly the healthiest elderly. The resulting lack of knowledge has led to inconsistent guidelines, mainly based on systolic blood pressure (SBP), cardiovascular disease (CVD) but not on frailty despite the high prevalence in oldest-old. This may lead to variation how General Practitioners (GPs) treat hypertension. Our aim was to investigate treatment variation of GPs in oldest-olds across countries and to identify the role of frailty in that decision...
April 20, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28356129/the-effects-of-probiotic-and-synbiotic-supplementation-on-metabolic-syndrome-indices-in-adults-at-risk-of-type-2-diabetes-study-protocol-for-a-randomized-controlled-trial
#10
Nazila Kassaian, Ashraf Aminorroaya, Awat Feizi, Parvaneh Jafari, Masoud Amini
BACKGROUND: The incidence of type 2 diabetes, cardiovascular diseases, and obesity has been rising dramatically; however, their pathogenesis is particularly intriguing. Recently, dysbiosis of the intestinal microbiota has emerged as a new candidate that may be linked to metabolic diseases. We hypothesize that selective modulation of the intestinal microbiota by probiotic or synbiotic supplementation may improve metabolic dysfunction and prevent diabetes in prediabetics. In this study, a synthesis and study of synbiotics will be carried out for the first time in Iran...
March 29, 2017: Trials
https://www.readbyqxmd.com/read/28348073/from-benign-adrenal-incidentaloma-to-adrenocortical-carcinoma-an-exceptional-random-event
#11
Ines Belmihoub, Stephane Silvera, Mathilde Sibony, Bertrand Dousset, Paul Legmann, Xavier Bertagna, Jerome Bertherat, Guillaume Assie
New European guidelines for the management of adrenal incidentalomas were recently released. One of the most novel recommendations is to stop following patients when they present a typical, small and non-secreting adenoma. We report here the case of a 71-year-old man with such an adenoma, who developed an adrenocortical carcinoma (ACC) fourteen years later, with subsequent metastases and death. Clinically he had a normal blood pressure and no sign of hormonal hypersecretion. The hormonal work-up showed no hormone excess: urinary free cortisol level was normal, the diurnal cortisol rhythm was respected and urinary catecholamine metabolites levels were normal...
March 27, 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28347475/current-trends-in-vasopressor-use-to-the-operating-room-a-pharmacoepidemiologic-study-in-french-teaching-and-military-hospitals
#12
M Bauducel, V Piriou, C Dussart, G Aulagner, X Armoiry
OBJECTIVES: Phenylephrine, ephedrine and norepinephrine are the vasopressors most commonly used in the operating room to treat anaesthesia-induced hypotension. Two new diluted forms of phenylephrine were released in 2011 (500μg/10mL and 500μg/5mL). We initiated a study to evaluate trends in the use of vasopressors in the operating room in French hospitals over the period 2011-2014. METHODS: We conducted a longitudinal, retrospective, observational study between 2011 and 2014 in French teaching and military hospitals...
March 24, 2017: Annales Pharmaceutiques Françaises
https://www.readbyqxmd.com/read/28341615/design-and-usability-of-a-heart-failure-mhealth-system-a-pilot-study
#13
Nagla Alnosayan, Samir Chatterjee, Ala Alluhaidan, Edward Lee, Linda Houston Feenstra
BACKGROUND: Despite the advances in mobile health (mHealth) systems, little is known about patients' and providers' experiences using a new mHealth system design. OBJECTIVE: This study aimed to understand challenges and provide design considerations for a personalized mHealth system that could effectively support heart failure (HF) patients after they transition into the home environment. METHODS: Following exploratory interviews with nurses and preventive care physicians, an mHealth system was developed...
March 24, 2017: JMIR Human Factors
https://www.readbyqxmd.com/read/28289965/novel-insights-into-the-pathophysiology-and-clinical-aspects-of-diabetic-nephropathy
#14
REVIEW
Zubair Ilyas, Joumana T Chaiban, Armand Krikorian
Diabetic nephropathy (DN) is a well-described complication of diabetes mellitus and the leading cause of end stage renal disease (ESRD). Although increased albuminuria has been the gold standard for screening, data suggests that renal damage starts long before the onset of clinically apparent increases in macro and even micro-albuminuria. Clinical practice guidelines for the prevention of DN have been traditionally focused on the control of serum glucose, blood pressure and dyslipidemia, with some focus on the renin-angiotensin-aldosterone system (RAAS) as a main target for successful therapy...
March 2017: Reviews in Endocrine & Metabolic Disorders
https://www.readbyqxmd.com/read/28285069/sacubitril-valsartan-the-newest-addition-to-the-toolbox-for-guideline-directed-medical-therapy-of-heart-failure
#15
REVIEW
Jo E Rodgers
Sacubitril/valsartan combines a neprilysin inhibitor with an angiotensin receptor blocker. As an inhibitor of neprilysin, an enzyme that degrades biologically active natriuretic peptides, this first-in-class therapy increases levels of circulating natriuretic peptides, resulting in natriuretic, diuretic, and vasodilatory effects. In patients with chronic New York Heart Association class II-IV heart failure with reduced ejection fraction, the PARADIGM-HF trial demonstrated that sacubitril/valsartan significantly reduced the primary endpoint of cardiovascular mortality and heart failure hospitalization, compared with enalapril...
March 9, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28275938/role-of-coronary-calcium-for-risk-stratification-and-prognostication
#16
REVIEW
Negin Nezarat, Michael Kim, Matthew Budoff
A multitude of studies now support the understanding that an increased coronary artery calcium (CAC) score represents advanced atherosclerosis and high risk for cardiovascular disease (CVD) and, as such, should be treated with conventional therapies for those considered high risk. Data is now available to guide treatment with aspirin, statins, and lifestyle management. The new ACC/AHA 2013 guidelines support intensifying statin therapy when the CAC is ≥75th percentile for age, sex, and ethnicity/race or when the calcium score is ≥300 Agatston units...
February 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28237685/evaluation-of-a-new-handheld-point-of-care-blood-gas-analyser-using-100-equine-blood-samples
#17
David Bardell, Eleanor West, J Mark Senior
OBJECTIVES: To determine whether the Enterprise point-of-care blood analysis system (EPOC) produces results in agreement with two other blood gas analysers in regular clinical use (i-STAT and Radiometer ABL77) and to investigate the precision of the new machine when used with equine whole blood. STUDY DESIGN: Prospective, randomized, non-blinded, comparative laboratory analyser study. ANIMALS: Horses admitted to a university teaching hospital requiring arterial or venous blood gas analysis as part of their routine clinical management...
February 22, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28178413/spontaneous-intracerebral-hemorrhage-management
#18
REVIEW
Jun Yup Kim, Hee-Joon Bae
Spontaneous non-traumatic intracerebral hemorrhage (ICH) remains a significant cause of mortality and morbidity throughout the world. To improve the devastating course of ICH, various clinical trials for medical and surgical interventions have been conducted in the last 10 years. Recent large-scale clinical trials have reported that early intensive blood pressure reduction can be a safe and feasible strategy for ICH, and have suggested a safe target range for systolic blood pressure. While new medical therapies associated with warfarin and non-vitamin K antagonist oral anticoagulants have been developed to treat ICH, recent trials have not been able to demonstrate the overall beneficial effects of surgical intervention on mortality and functional outcomes...
January 2017: Journal of Stroke
https://www.readbyqxmd.com/read/28161697/in-the-wake-of-systolic-blood-pressure-intervention-trial-new-targets-for-improving-hypertension-management-in-chronic-kidney-disease
#19
Crystal C Tyson, Thomas M Coffman
Systolic Blood Pressure Intervention Trial (SPRINT) was a multicenter randomized controlled trial showing the significant benefit of intensive reduction of blood pressure to a target of 120 mm Hg in individuals with hypertension and elevated cardiovascular risk. Because SPRINT includes the largest cohort of adults with chronic kidney disease (CKD) to be prospectively studied in a hypertension intervention trial, it has particular relevance to the field of nephrology. Here, we review the findings of SPRINT and assess their potential impact on guidelines for treatment of hypertension in patients with CKD...
2017: Nephron
https://www.readbyqxmd.com/read/28157742/stroke-epidemiology-and-risk-factor-management
#20
REVIEW
Amy Guzik, Cheryl Bushnell
PURPOSE OF REVIEW: Death from stroke has decreased over the past decade, with stroke now the fifth leading cause of death in the United States. In addition, the incidence of new and recurrent stroke is declining, likely because of the increased use of specific prevention medications, such as statins and antihypertensives. Despite these positive trends in incidence and mortality, many strokes remain preventable. The major modifiable risk factors are hypertension, diabetes mellitus, tobacco smoking, and hyperlipidemia, as well as lifestyle factors, such as obesity, poor diet/nutrition, and physical inactivity...
February 2017: Continuum: Lifelong Learning in Neurology
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