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Hypertension treatment review

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https://www.readbyqxmd.com/read/28213937/targeting-phosphodiesterase-5-as-a-therapeutic-option-against-myocardial-ischemia-reperfusion-injury-and-in-treating-heart-failure
#1
REVIEW
Sevil Korkmaz-Icöz, Tamás Radovits, Gábor Szabó
Phosphodiesterase type 5 (PDE5) selectively hydrolyses the second messenger cyclic 3´-5´guanosine monophosphate (cGMP) into 5'-GMP, thereby regulating its intracellular concentrations. Dysregulation of the cGMP-dependent pathway plays a significant role in various cardiovascular diseases. Therefore, its modulation by drugs, such as PDE5 inhibitors, may represent an effective therapeutic approach. There are currently four PDE5 inhibitors available for the treatment of erectile dysfunction: sildenafil, vardenafil, tadalafil, and avanafil...
February 18, 2017: British Journal of Pharmacology
https://www.readbyqxmd.com/read/28210913/dietary-and-commercialized-fructose-sweet-or-sour
#2
REVIEW
Aslihan Yerlikaya, Tuncay Dagel, Christopher King, Masanari Kubawara, Miguel A Lanaspa, Ana Andres-Hernando, Adrian Covic, Jacek Manitius, Alan A Sag, Mehmet Kanbay
Metabolic syndrome and diabetes are main health problems of modern life in the twenty-first century. Alarming ratios of global prevalence lead to conduct more and more researches about etiological factors and pathogenesis. Disease mechanism is elementary for advancing more efficient and practicable treatment methods. Concurrent increase in both fructose consumption with Western diet and metabolic syndrome has revealed fructose hypothesis that suggests fructose as one of etiological factor of metabolic syndrome (insulin resistance, central obesity, hypertension, etc...
February 16, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28209226/sleep-apnea-types-mechanisms-and-clinical-cardiovascular-consequences
#3
REVIEW
Shahrokh Javaheri, Ferran Barbe, Francisco Campos-Rodriguez, Jerome A Dempsey, Rami Khayat, Sogol Javaheri, Atul Malhotra, Miguel A Martinez-Garcia, Reena Mehra, Allan I Pack, Vsevolod Y Polotsky, Susan Redline, Virend K Somers
Sleep apnea is highly prevalent in patients with cardiovascular disease. These disordered breathing events are associated with a profile of perturbations that include intermittent hypoxia, oxidative stress, sympathetic activation, and endothelial dysfunction, all of which are critical mediators of cardiovascular disease. Evidence supports a causal association of sleep apnea with the incidence and morbidity of hypertension, coronary heart disease, arrhythmia, heart failure, and stroke. Several discoveries in the pathogenesis, along with developments in the treatment of sleep apnea, have accumulated in recent years...
February 21, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28201968/common-drugs-for-stabilization-of-renal-function-in-the-progression-of-diabetic-nephropathy-and-their-relations-with-hypertension-therapy
#4
Yuxuan Wang, Chengcheng Wang, Xiuli Zhang, Harvest F Gu, Liang Wu
Diabetic nephropathy is characterized by hypertension, progressive albuminuria, glomerulosclerosis and declines in glomerular filtration rate leading to end stage renal disease. Although the pathogenesis of diabetic nephropathy is not fully understood, current treatment of the patients with diabetic nephropathy is mainly based upon the control of hyperglycaemia and management of blood pressures. Several drugs, which are originally developed for hypertension therapy, have been adopted for stabilization of renal function in diabetic nephropathy...
February 14, 2017: Current Diabetes Reviews
https://www.readbyqxmd.com/read/28201851/the-design-of-clinical-trials-in-portal-hypertension
#5
Juan G Abraldes, Guadalupe Garcia-Tsao
Portal hypertension (PH) is the main consequence of cirrhosis and is responsible for the majority of its complications. Gastroesophageal varices and variceal hemorrhage are direct consequences of PH; therefore, most clinical trials in PH have been directed toward treating or preventing variceal hemorrhage. However, varices and variceal hemorrhage are not isolated events; they must be considered in the context of the presence (or absence) of other complications of cirrhosis/PH. Cirrhosis progresses across different stages, each with a different prognosis and pathophysiology and hence different therapeutic targets...
February 2017: Seminars in Liver Disease
https://www.readbyqxmd.com/read/28194494/college-inflammatory-bowel-disease-c-ibd-day-a-targeted-approach-to-shared-decision-making-in-college-age-students-with-ibd-a-2-year-pilot-project
#6
Kofi Clarke, Mohammad Bilal, Heitham Abdul-Baki, Paul Lebovitz, Sandra El-Hachem
BACKGROUND: Adherence to treatment is a key therapeutic goal in chronic disorders including diabetes, inflammatory bowel disease (IBD), and hypertension. Non-adherence has been associated with increased health care costs. Previous studies have evaluated adherence to treatment in inflammatory bowel disease, as well as predictors of non-adherence. Higher belief of necessity for medications and membership of IBD patient organizations have been associated with higher medication adherence...
February 13, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28190873/the-role-of-uric-acid-in-hypertension-of-adolescents-prehypertension-and-salt-sensitivity-of-blood-pressure
#7
Yang Wang, Jia-Wen Hu, Yong-Bo Lv, Chao Chu, Ke-Ke Wang, Wen-Ling Zheng, Yu-Meng Cao, Zu-Yi Yuan, Jian-Jun Mu
Uric acid is the end product of purine metabolism. Metabolic disorders of uric acid are associated with many disease states. Substantial evidence suggests the possible role of uric acid as a mediator of high blood pressure. Elevated uric acid is closely associated with new onset essential hypertension in adolescents and prehypertension; and urate-lowering agents can significantly improve these early stages of hypertension. Uric acid also influences salt sensitivity of blood pressure through two phases. Local renin-angiotensin-aldosterone system activation initiates renal damage, arteriolopathy, and endothelium dysfunction, which is followed by the dysregulation of sodium homeostasis, thereby leading to increased salt sensitivity...
February 13, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28190786/survival-in-portopulmonary-hypertension-outcomes-of-the-united-kingdom-national-pulmonary-arterial-hypertension-registry
#8
Sasiharan Sithamparanathan, Arun Nair, Logan Thirugnanasothy, J Gerry Coghlan, Robin Condliffe, Konstantinos Dimopoulos, Charlie A Elliot, Andrew J Fisher, Sean Gaine, J Simon R Gibbs, Michael A Gatzoulis, Clive E Handler, Luke S Howard, Martin Johnson, David G Kiely, James L Lordan, Andrew J Peacock, Joanna Pepke-Zaba, Benjamin E Schreiber, Karen K K Sheares, Stephen J Wort, Paul A Corris
BACKGROUND: Portopulmonary hypertension (PoPH) is a rare condition associated with poor survival, and the effect of modern therapies that target pulmonary arterial hypertension (PAH) on long-term outcome is unknown. This study investigated the baseline characteristics and survival in the cohort of patients diagnosed with PoPH in the United Kingdom National Pulmonary Hypertension Service. METHODS: A retrospective review was conducted of all incident treatment-naïve patients with PoPH within the United Kingdom national registry diagnosed between January 2001 and December 2010...
December 31, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28190578/quarter-dose-quadruple-combination-therapy-for-initial-treatment-of-hypertension-placebo-controlled-crossover-randomised-trial-and-systematic-review
#9
Clara K Chow, Jay Thakkar, Alex Bennett, Graham Hillis, Michael Burke, Tim Usherwood, Kha Vo, Kris Rogers, Emily Atkins, Ruth Webster, Michael Chou, Hakim-Moulay Dehbi, Abdul Salam, Anushka Patel, Bruce Neal, David Peiris, Henry Krum, John Chalmers, Mark Nelson, Christopher M Reid, Mark Woodward, Sarah Hilmer, Simon Thom, Anthony Rodgers
BACKGROUND: Globally, most patients with hypertension are treated with monotherapy, and control rates are poor because monotherapy only reduces blood pressure by around 9/5 mm Hg on average. There is a pressing need for blood pressure-control strategies with improved efficacy and tolerability. We aimed to assess whether ultra-low-dose combination therapy could meet these needs. METHODS: We did a randomised, placebo-controlled, double-blind, crossover trial of a quadpill-a single capsule containing four blood pressure-lowering drugs each at quarter-dose (irbesartan 37·5 mg, amlodipine 1·25 mg, hydrochlorothiazide 6·25 mg, and atenolol 12·5 mg)...
February 9, 2017: Lancet
https://www.readbyqxmd.com/read/28188041/chronic-obstructive-pulmonary-disease-and-atrial-fibrillation-an-unknown-relationship
#10
REVIEW
Christos A Goudis
Chronic obstructive pulmonary disease (COPD) is independently associated with atrial fibrillation (AF). Decreased oxygenation, hypercapnia, pulmonary hypertension, diastolic dysfunction, oxidative stress, inflammation, changes in atrial size by altered respiratory physiology, increased arrhythmogenicity from nonpulmonary vein foci commonly located in the right atrium, and respiratory drugs have been implicated in the pathogenesis of AF in COPD. The understanding of the relationship between COPD and AF is of particular importance, as the presence of the arrhythmia has significant impact on mortality, especially in COPD exacerbations...
February 7, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28185814/obstructive-sleep-apnea-and-pulmonary-hypertension-in-children
#11
REVIEW
David G Ingram, Alvin V Singh, Zarmina Ehsan, Brian F Birnbaum
Obstructive sleep apnea (OSA) is a common pediatric breathing disorder, affecting 1-5% of all children. Pulmonary hypertension (PH), a severe complication of OSA, is associated with significant morbidity and mortality. Despite this important relationship between OSA and PH, there is sparse literature addressing this subject in children. This review will examine the putative relationship between OSA and PH, synthesize the available literature in children, and suggest a reasonable approach, despite limited data, for clinicians...
January 11, 2017: Paediatric Respiratory Reviews
https://www.readbyqxmd.com/read/28184289/novel-approaches-for-treating-hypertension
#12
REVIEW
Andrew J Freeman, Antony Vinh, Robert E Widdop
Hypertension, or high blood pressure, is a prevalent yet modifiable risk factor for cardiovascular disease. While there are many effective treatments available to combat hypertension, patients often require at least two to three medications to control blood pressure, although there are patients who are resistant to such therapies. This short review will briefly update on recent clinical advances and potential emerging therapies and is intended for a cross-disciplinary readership.
2017: F1000Research
https://www.readbyqxmd.com/read/28182166/reducing-the-risk-of-stroke-in-elderly-patients-with-non-valvular-atrial-fibrillation-a-practical-guide-for-clinicians
#13
REVIEW
Joanne M Foody
Non-valvular atrial fibrillation (NVAF) significantly contributes to the burden of stroke, particularly in elderly patients. The challenge of optimizing anticoagulation therapy is balancing efficacy and bleeding risk, especially as the same patients at high risk of stroke also tend to be at high risk of bleeding. Treating the elderly patient with NVAF presents special challenges because of their heightened risk for both stroke and bleeding. Despite clinical trial data and evidence-based guidelines, surveys indicate that physicians underuse anticoagulation in older patients for reasons that include overemphasis of bleeding risk, particularly with the increased risk of falling, at the cost of thromboembolic risk...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28181201/management-of-hypertension-in-the-elderly-and-frail-elderly
#14
REVIEW
Claudio Ferri, Livia Ferri, Giovambattista Desideri
An elevated systolic but not diastolic blood pressure level represents a common finding in elderly patients and is associated with an increased risk for developing coronary artery disease, cerebrovascular disease, peripheral artery disease, progressive cognitive decline and renal failure. Although less frequently, elderly patients manifest not only with systolic but also diastolic hypertension. Also in this case, the elderly patient will present an increased risk for developing hypertension-related abnormalities...
February 8, 2017: High Blood Pressure & Cardiovascular Prevention: the Official Journal of the Italian Society of Hypertension
https://www.readbyqxmd.com/read/28179257/interplay-between-renal-endothelin-and-purinergic-signaling-systems
#15
Eman Y Gohar, Malgorzata Kasztan, David M Pollock
Alterations in extracellular fluid volume regulation and sodium balance may result in the development and maintenance of salt-dependent hypertension, a major risk factor for cardiovascular disease. Numerous pathways contribute to the regulation of sodium excretion and blood pressure, including endothelin and purinergic signaling. Increasing evidence suggests a link between purinergic receptor activation and endothelin production within the renal collecting duct as a means of promoting natriuresis. A better understanding of the relationship between these two systems, especially in regard to sodium homeostasis, will fill a significant knowledge gap and may provide novel antihypertensive treatment options...
February 8, 2017: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/28179050/cerebral-amyloid-angiopathy-in-stroke-medicine
#16
Frank Block, Manuel Dafotakis
BACKGROUND: Cerebral amyloid angiopathy (CAA) is a degenerative vasculopathy that is classically associated with lobar intracerebral or sulcal hemorrhage. Its prevalence is estimated at 30% in the seventh decade and 50% in the eighth and ninth decades. In this review, we summarize the risks linked to CAA with respect to the treatment and prevention of stroke. METHODS: This review is based on pertinent publications retrieved by a selective search employing the terms "amyloid cerebral angiopathy," "stroke," "intra - cerebral bleeding," and "acute stroke therapy...
January 20, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28175991/spontaneous-cerebrospinal-fluid-leaks-in-the-anterior-skull-base-secondary-to-idiopathic-intracranial-hypertension
#17
Gabriel Martínez-Capoccioni, Ramón Serramito-García, Maria Martín-Bailón, Alfredo García-Allut, Carlos Martín-Martín
Spontaneous cerebrospinal fluid (CSF) leaks represent a clinical entity in which CSF rhinorrhea occurs in the absence of any inciting event. Spontaneous CSF leaks are associated with elevated intracranial pressure (ICP) or have underlying idiopathic intracranial hypertension (IIH). We report a cohort of patients who have undergone nasal endoscopic repair for spontaneous CSF leaks. We review our perioperative complications and the effectiveness of the nasal endoscopic approach to repair spontaneous CSF leaks...
February 7, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28170483/diagnosis-and-treatment-of-pituitary-adenomas-a-review
#18
Mark E Molitch
Importance: Pituitary adenomas may hypersecrete hormones or cause mass effects. Therefore, early diagnosis and treatment are important. Observations: Prevalence of pituitary adenomas ranges from 1 in 865 adults to 1 in 2688 adults. Approximately 50% are microadenomas (<10 mm); the remainder are macroadenomas (≥10 mm). Mass effects cause headache, hypopituitarism, and visual field defects. Treatments include transsphenoidal surgery, medical therapies, and radiotherapy...
February 7, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28169858/central-nervous-system-infections-in-immunocompromised-patients
#19
Romain Sonneville, Eric Magalhaes, Geert Meyfroidt
PURPOSE OF REVIEW: Although rare, central nervous system (CNS) infections are increasingly being recognized in immunocompromised patients. The goal of the present review is to provide a practical diagnostic approach for the intensivist, and to briefly discuss some of the most prevalent conditions. RECENT FINDINGS: Immunocompromised patients presenting with new neurological symptoms should always be suspected of a CNS infection. These infections carry a poor prognosis, especially if intracranial hypertension, severely altered mental status or seizures are present...
February 4, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28169156/posterior-reversible-encephalopathy-syndrome-associated-with-dose-adjusted-epoch-etoposide-prednisone-vincristine-cyclophosphamide-doxorubicin-chemotherapy
#20
Abby E Floeter, Amila Patel, Melinda Tran, Marc C Chamberlain, Paul C Hendrie, Ajay K Gopal, Ryan D Cassaday
INTRODUCTION: The purpose of our study was to identify the key risk factors for the development of posterior reversible encephalopathy syndrome (PRES) after administration of the combination chemotherapy regimen, DA-EPOCH (dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin). MATERIALS AND METHODS: We performed a retrospective medical record review of patients receiving DA-EPOCH with or without rituximab (DA-EPOCH ± R) at our institution from July 2012 to September 2014...
January 10, 2017: Clinical Lymphoma, Myeloma & Leukemia
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