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Masked Hypertension

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https://www.readbyqxmd.com/read/28100465/prevalence-of-masked-hypertension-among-us-adults-with-nonelevated-clinic-blood-pressure
#1
Y Claire Wang, Daichi Shimbo, Paul Muntner, Andrew E Moran, Lawrence R Krakoff, Joseph E Schwartz
Masked hypertension (MHT), defined as nonelevated blood pressure (BP) in the clinic setting and elevated BP assessed by ambulatory monitoring, is associated with increased risk of target organ damage, cardiovascular disease, and mortality. Currently, no estimate of MHT prevalence exists for the general US population. After pooling data from the Masked Hypertension Study (n = 811), a cross-sectional clinical investigation of systematic differences between clinic BP and ambulatory BP (ABP) in a community sample of employed adults in the New York City metropolitan area (2005-2012), and the National Health and Nutrition Examination Survey (NHANES; 2005-2010; n = 9,316), an ongoing nationally representative US survey, we used multiple imputation to impute ABP-defined hypertension status for NHANES participants and estimate MHT prevalence among the 139 million US adults with nonelevated clinic BP, no history of overt cardiovascular disease, and no use of antihypertensive medication...
January 18, 2017: American Journal of Epidemiology
https://www.readbyqxmd.com/read/28099129/the-association-between-obesity-hypertension-and-left-ventricular-mass-in-adolescents
#2
Saime Ergen Dibeklioglu, Berna Şaylan Çevik, Banu Acar, Zeynep Birsin Özçakar, Nermin Uncu, Nazlı Kara, Şemsa Çaycı, Nilgün Çakar
BACKGROUND: Obesity and hypertension (HT) are well known cardiac risk factors. Our goal was to show that even if arterial blood pressure (BP) measurements of obese adolescents are normal during clinical examination, ambulatory blood pressure monitoring (ABPM) can be high, may include cardiac involvement and can also detect left ventricular mass indices (LVMI) value for obese adolescents to diagnose left ventricular hypertrophy (LVH). METHODS: This study included 130 children (57 obese hypertensive, 36 obese normotensive, 14 normal weight hypertensive and 23 normal weight normotensive)...
January 18, 2017: Journal of Pediatric Endocrinology & Metabolism: JPEM
https://www.readbyqxmd.com/read/28070059/differences-in-cardiovascular-responses-to-alamandine-in-two-kidney-one-clip-hypertensive-and-normotensive-rats
#3
Ava Soltani Hekmat, Kazem Javanmardi, Amin Kouhpayeh, Ehsan Baharamali, Mojtaba Farjam
BACKGROUND: Alamandine is a newly discovered component of the renin-angiotensin system, which regulates blood pressure. In this study, the effect of alamandine on cardiovascular parameters in two-kidney, one clip (2K1C) hypertensive rats and normotensive rats, and the possible roles of the angiotensin II type 1 receptor (AT1R) and the PD123319-sensitive receptors in mediating this effect was investigated.Methods and Results:The cardiovascular parameters were monitored for 10 min before the infusion of the drugs or saline, and for 30 min afterward...
January 7, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28052877/blood-pressure-measurement-anno-2016
#4
REVIEW
Jan A Staessen, Yan Li, Azusa Hara, Kei Asayama, Eamon Dolan, Eoin O'Brien
The rational management of hypertension (HT) inevitably starts with accurate measurement of blood pressure (BP). The recently published Systolic Blood Pressure Intervention Trial implemented automated office BP measurement. However, event-driven studies have overwhelmingly indicated that out-of-the-office BP monitoring is a prerequisite for risk stratification and for identifying the need of initiating or adjusting antihypertensive drug treatment. 24-Hour ambulatory BP monitoring is the preferred method of BP measurement and addresses major issues not covered by conventional or automated office BP measurement or home BP monitoring, such as reliably diagnosing nocturnal HT (the time window of the day during which BP is most predictive of adverse cardiovascular outcome), hypotension, or masked HT, a condition that affects 15% of the general populations and carries a risk equal to that of HT on both office and out-of-the-office BP measurement...
January 4, 2017: American Journal of Hypertension
https://www.readbyqxmd.com/read/28034462/masked-hypertension-rather-than-white-coat-hypertension-has-a-prognostic-role-in-patients-with-non-dialysis-chronic-kidney-disease
#5
Cheng Wang, Jun Zhang, Yan Li, Xinxin Ma, Zengchun Ye, Hui Peng, Tanqi Lou
OBJECTIVE: Masked hypertension (MHT) and white-coat hypertension (WCHT) have been studied among the general population and hypertensive patients. However, little insight is available on the prognosis of MHT and WCHT in patients with chronic kidney disease (CKD). We investigated the role of MHT and WCHT in the prognosis of patients with non-dialysis CKD. METHODS: A prospective cohort study was conducted between July 2010 and December 2014. A total of 588 patients with non-dialysis CKD were enrolled for ambulatory and clinic blood pressure (BP) monitoring...
December 21, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28033135/omega-3-fatty-acid-supplementation-and-warfarin-a-lethal-combination-in-traumatic-brain-injury
#6
Brian W Gross, Maria Gillio, Cole D Rinehart, Caitlin A Lynch, Frederick B Rogers
Polyunsaturated fatty acids such as omega-3 eicosapentaenoic acid and omega-6 docosahexaenoic acid, found in over-the-counter fish oil supplements, are often consumed for their beneficial, prophylactic, anti-inflammatory effects. Although the mechanisms of action are not fully known, a diet rich in polyunsaturated fats may reduce the risk of hyperlipidemia, atherosclerosis, high low-density lipoprotein cholesterol levels, hypertension, and inflammatory diseases. Masked by its many benefits, the risks of omega-3 fatty acid supplementation are often underappreciated, particularly its ability to inhibit platelet aggregation and promote bleeding in patients taking anticoagulant medications...
January 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28028191/clinic-versus-daytime-ambulatory-blood-pressure-difference-in-hypertensive-patients-the-impact-of-age-and-clinic-blood-pressure
#7
José R Banegas, Luis M Ruilope, Alejandro de la Sierra, Ernest Vinyoles, Manuel Gorostidi, Juan J de la Cruz, Julián Segura, Anna Oliveras, Nieves Martell, Juan García-Puig, Bryan Williams
Clinic blood pressure (BP) is usually higher than daytime ambulatory BP in hypertensive patients, but some recent studies have challenged this view, suggesting that this relationship is strongly influenced by age. We used the Spanish ambulatory BP monitoring cohort to examine differences between clinic and daytime BP by age among 104 639 adult hypertensive patients (office systolic/diastolic BP ≥140/90 mm Hg or treated) in usual primary-care practice, across the wide age spectrum. To assess the impact of age, cardiovascular variables, and clinic BP on the clinic-daytime BP differences, we built multivariable regression models of the average BP differences, white-coat hypertension (high clinic BP and normal daytime BP), and masked hypertension (normal clinic BP and high daytime BP)...
December 27, 2016: Hypertension
https://www.readbyqxmd.com/read/28012774/-intermittent-left-bundle-branch-block-reversal-to-normal-conduction-during-general-anesthesia
#8
Ana Maria Oliveira Correia da Silva, Emília Alexandra Gaspar Lima da Silva
BACKGROUND AND OBJECTIVES: Transient changes in intraoperative cardiac conduction are uncommon. Rare cases of the development or remission of complete left bundle branch block under general and locoregional anesthesia associated with myocardial ischemia, hypertension, tachycardia, and drugs have been reported. Complete left bundle branch block is an important clinical manifestation in some chronic hypertensive patients, which may also be a sign of coronary artery disease, aortic valve disease, or underlying cardiomyopathy...
December 21, 2016: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28003768/symptom-profiles-of-subsyndromal-depression-in-disease-clusters-of-diabetes-excess-weight-and-progressive-cerebrovascular-conditions-a-promising-new-type-of-finding-from-a-reliable-innovation-to-estimate-exhaustively-specified-multiple-indicators-multiple-causes
#9
Richard B Francoeur
Addressing subsyndromal depression in cerebrovascular conditions, diabetes, and obesity reduces morbidity and risk of major depression. However, depression may be masked because self-reported symptoms may not reveal dysphoric (sad) mood. In this study, the first wave (2,812 elders) from the New Haven Epidemiological Study of the Elderly (EPESE) was used. These population-weighted data combined a stratified, systematic, clustered random sample from independent residences and a census of senior housing. Physical conditions included progressive cerebrovascular disease (CVD; hypertension, silent CVD, stroke, and vascular cognitive impairment [VCI]) and co-occurring excess weight and/or diabetes...
2016: Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy
https://www.readbyqxmd.com/read/27993589/adherence-to-fixed-combination-versus-unfixed-travoprost-0-004-timolol-0-5-for-glaucoma-or-ocular-hypertension-a-randomized-trial
#10
Howard S Barnebey, Alan L Robin
PURPOSE: To assess adherence to treatment with fixed-combination travoprost 0.004%/timolol 0.5% (TTFC) compared with separate containers of travoprost 0.004% and timolol 0.5% (TRAV+TIM; unfixed) using electronic dosing aids DESIGN: Randomized, controlled, observer-masked clinical trial METHODS: Setting: Two US clinical sites Patient Population: Eligible patients were adults diagnosed with open-angle glaucoma or ocular hypertension. Patients (n=81) were sequentially randomized 1:1 to receive TTFC or TRAV+TIM for 12 months...
December 16, 2016: American Journal of Ophthalmology
https://www.readbyqxmd.com/read/27981433/ambulatory-blood-pressure-monitoring-in-the-diagnosis-and-treatment-of-hypertension
#11
Md Shahidul Islam
Clinicians should take initiatives to establish ambulatory blood pressure monitoring (ABPM) services in their own practice, or to ensure that they have access to such services elsewhere. Whenever possible, ABPM should be performed in suitable cases, where it is likely to deliver clinically useful information for making a correct diagnosis, or for tailoring the anti-hypertensive treatment regimen for each individual patient. ABPM is clinically useful, among others, for identifying people with "masked normotension", "masked hypertension", "sleep-time hypertension", and "reduced decline of sleep-time blood pressure"...
December 16, 2016: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27979807/clinical-and-epidemiological-implications-of-24-hour-ambulatory-blood-pressure-monitoring-for-the-diagnosis-of-hypertension-in-kenyan-adults-a-population-based-study
#12
Anthony O Etyang, Ben Warne, Sailoki Kapesa, Kenneth Munge, Evasius Bauni, J Kennedy Cruickshank, Liam Smeeth, J Anthony G Scott
BACKGROUND: The clinical and epidemiological implications of using ambulatory blood pressure monitoring (ABPM) for the diagnosis of hypertension have not been studied at a population level in sub-Saharan Africa. We examined the impact of ABPM use among Kenyan adults. METHODS AND RESULTS: We performed a nested case-control study of diagnostic accuracy. We selected an age-stratified random sample of 1248 adults from the list of residents of the Kilifi Health and Demographic Surveillance System in Kenya...
December 15, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27957422/unmasked-chronic-renal-function-deterioration-after-unilateral-adrenalectomy-in-patients-with-primary-aldosteronism
#13
Su Min Park, Woo Jin Jung, Jong Man Park, Harin Rhee, Il Young Kim, Eun Young Seong, Dong Won Lee, Soo Bong Lee, Ihm Soo Kwak, Nari Shin, Sang Heon Song
We report 2 cases of chronic estimated glomerular filtration rate (eGFR) decline after unilateral adrenalectomy due to primary aldosteronism. The patients were diagnosed with unilateral adrenal cortical adenoma releasing aldosterone. Two patients were examined for hypertension and hypokalemia. Unilateral laparoscopic adrenalectomy was performed in both cases, and pathology confirmed adrenal cortical adenoma. After adrenalectomy, hypertension and hypokalemia improved to within normal range. However, the eGFR decreased postoperatively, and abdominal computed tomography scan showed decreased kidney size compared to previous images...
December 2016: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/27956942/obesity-and-hypertensive-heart-disease-focus-on-body-composition-and-sex-differences
#14
REVIEW
Giovanni de Simone, Costantino Mancusi, Raffaele Izzo, Maria Angela Losi, L Aldo Ferrara
There is evidence that hypertension is frequently associated with overweight/obesity even in kids and adolescents. Either conditions influence development of left ventricular (LV) hypertrophy (LVH), through different biological and hemodynamic mechanisms: obesity is conventionally thought to elicit a coherent growth of LV chamber dimensions and myocardial wall thickness (eccentric LV geometry), whereas a more accentuated increase in wall-thickness (concentric LV geometry) is attributed to hypertension. While during youth these differences are visible, proportion of LV concentric geometry, the most harmful LV geometric pattern, sharply raises in obese individuals during middle age, and becomes the most frequent geometric patterns among obese-hypertensive individuals...
2016: Diabetology & Metabolic Syndrome
https://www.readbyqxmd.com/read/27942587/chorioretinal-thinning-in-chronic-kidney-disease-links-to-inflammation-and-endothelial-dysfunction
#15
Craig Balmforth, Job J M H van Bragt, Titia Ruijs, James R Cameron, Robert Kimmitt, Rebecca Moorhouse, Alicja Czopek, May Khei Hu, Peter J Gallacher, James W Dear, Shyamanga Borooah, Iain M MacIntyre, Tom M C Pearson, Laura Willox, Dinesh Talwar, Muriel Tafflet, Christophe Roubeix, Florian Sennlaub, Siddharthan Chandran, Baljean Dhillon, David J Webb, Neeraj Dhaun
BACKGROUND. Chronic kidney disease (CKD) is strongly associated with cardiovascular disease and there is an established association between vasculopathy affecting the kidney and eye. Optical coherence tomography (OCT) is a novel, rapid method for high-definition imaging of the retina and choroid. Its use in patients at high cardiovascular disease risk remains unexplored. METHODS. We used the new SPECTRALIS OCT machine to examine retinal and retinal nerve fiber layer (RNFL) thickness, macular volume, and choroidal thickness in a prospective cross-sectional study in 150 subjects: 50 patients with hypertension (defined as a documented clinic BP greater than or equal to 140/90 mmHg (prior to starting any treatment) with no underlying cause identified); 50 with CKD (estimated glomerular filtration rate (eGFR) 8-125 ml/min/1...
December 8, 2016: JCI Insight
https://www.readbyqxmd.com/read/27940231/superior-abdominal-4d-flow-mri-data-consistency-with-adjusted-preprocessing-workflow-and-noncontrast-acquisitions
#16
Eric J Keller, Jeremy D Collins, Cynthia Rigsby, James C Carr, Michael Markl, Susanne Schnell
RATIONALE AND OBJECTIVES: To assess the impact of an alternative preprocessing workflow on noncontrast- and contrast-enhanced abdominal four-dimensional flow magnetic resonance imaging (4D flow MRI) data consistency. MATERIALS AND METHODS: Twenty patients with cirrhosis and portal hypertension (5 women; 53 ± 10 years old) underwent 4D flow MRI at 3.0T before and after administration of 0.03 mmol/kg of gadofosveset trisodium with velocity sensitivities of 100 and 50 cm/s for arterial and venous flow quantifications, respectively...
December 8, 2016: Academic Radiology
https://www.readbyqxmd.com/read/27932229/regorafenib-for-patients-with-hepatocellular-carcinoma-who-progressed-on-sorafenib-treatment-resorce-a-randomised-double-blind-placebo-controlled-phase-3-trial
#17
Jordi Bruix, Shukui Qin, Philippe Merle, Alessandro Granito, Yi-Hsiang Huang, György Bodoky, Marc Pracht, Osamu Yokosuka, Olivier Rosmorduc, Valeriy Breder, René Gerolami, Gianluca Masi, Paul J Ross, Tianqiang Song, Jean-Pierre Bronowicki, Isabelle Ollivier-Hourmand, Masatoshi Kudo, Ann-Lii Cheng, Josep M Llovet, Richard S Finn, Marie-Aude LeBerre, Annette Baumhauer, Gerold Meinhardt, Guohong Han
BACKGROUND: There are no systemic treatments for patients with hepatocellular carcinoma (HCC) whose disease progresses during sorafenib treatment. We aimed to assess the efficacy and safety of regorafenib in patients with HCC who have progressed during sorafenib treatment. METHODS: In this randomised, double-blind, parallel-group, phase 3 trial done at 152 sites in 21 countries, adults with HCC who tolerated sorafenib (≥400 mg/day for ≥20 of last 28 days of treatment), progressed on sorafenib, and had Child-Pugh A liver function were enrolled...
December 5, 2016: Lancet
https://www.readbyqxmd.com/read/27930441/masked-tachycardia-a-predictor-of-adverse-outcome-in-hypertension
#18
Paolo Palatini, Gianpaolo Reboldi, Lawrence J Beilin, Edoardo Casiglia, Kazuo Eguchi, Yutaka Imai, Kazuomi Kario, Takayoshi Ohkubo, Sante D Pierdomenico, Joseph E Schwartz, Lindon Wing, Paolo Verdecchia
OBJECTIVE: The relative role of office heart rate (HR) and ambulatory HR for predicting major adverse cardiovascular events (MACEs) and mortality is not well known. Aim of this study was to investigate the association of white-coat tachycardia and masked tachycardia with MACE and mortality in hypertensive patients. METHODS: We performed 24-h ambulatory blood pressure and HR monitoring in 7602 hypertensive patients (4165 men) aged 52 ± 16 years enrolled in six prospective studies in Italy, Japan, and Australia...
December 7, 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27926690/changes-of-blood-pressure-patterns-and-target-organ-damage-in-patients-with-chronic-kidney-disease-results-of-the-aprodite-2-study
#19
Ran-Hui Cha, Hajeong Lee, Jung Pyo Lee, Eunjeong Kang, Young Rim Song, Yon Su Kim, Sung Gyun Kim
OBJECTIVE: Blood pressure (BP) control is the most established practice for preventing the progression of chronic kidney disease (CKD). We examined the BP control and nocturnal dipping pattern changes in hypertensive patients with CKD and their effects on target organ damages. METHODS: We recruited 378 hypertensive CKD patients from four centers in Korea. The patients underwent clinic and ambulatory BP monitoring at the time of enrollment and 1 year later. RESULTS: The BP control states at the two time points were as follows: true controlled (16...
December 6, 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27920072/clinic-blood-pressure-underestimates-ambulatory-blood-pressure-in-an-untreated-employer-based-us-population-results-from-the-masked-hypertension-study
#20
Joseph E Schwartz, Matthew M Burg, Daichi Shimbo, Joan E Broderick, Arthur A Stone, Joji Ishikawa, Richard Sloan, Tyla Yurgel, Steven Grossman, Thomas G Pickering
BACKGROUND: Ambulatory blood pressure (ABP) is consistently superior to clinic blood pressure (CBP) as a predictor of cardiovascular morbidity and mortality risk. A common perception is that ABP is usually lower than CBP. The relationship of the CBP minus ABP difference to age has not been examined in the United States. METHODS: Between 2005 and 2012, 888 healthy, employed, middle-aged (mean±SD age, 45±10.4 years) individuals (59% female, 7.4% black, 12% Hispanic) with screening BP <160/105 mm Hg and not taking antihypertensive medication completed 3 separate clinic BP assessments and a 24-hour ABP recording for the Masked Hypertension Study...
December 6, 2016: Circulation
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