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Antihypertensives treatment guideline review

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https://www.readbyqxmd.com/read/29678989/prescribing-and-deprescribing-antihypertensive-medication-in-older-people-by-dutch-general-practitioners-a-qualitative-study
#1
Tessa van Middelaar, Sophie D Ivens, Petra G van Peet, Rosalinde K E Poortvliet, Edo Richard, A Jeannette Pols, Eric P Moll van Charante
OBJECTIVES: To explore general practitioners' (GPs) routines and considerations on (de)prescribing antihypertensive medication (AHM) in older patients, their judgement on usability of the current guideline and needs for future support. DESIGN: Semistructured interviews. SETTING: Dutch general practice. PARTICIPANTS: Fifteen GPs were purposively sampled based on level of experience and practice characteristics until saturation was reached...
April 20, 2018: BMJ Open
https://www.readbyqxmd.com/read/29602409/single-pill-combinations-in-the-treatment-of-hypertension-in-adults-beyond-convenience
#2
REVIEW
Benoit Imbeault, Michel Vallée
Adequate blood pressure control in patients with hypertension remains the pillar of cardiovascular-event prevention. Smoking cessation, reduced dietary salt intake, physical exercise and weight loss contribute to better blood pressure control and reduced cardiovascular morbidity, but alone, they are often insufficient in doing so, and their success is highly dependent on individual patient motivation. Pharmacologic therapy, thus, remains necessary for most patients, and our conception of the optimal way of approaching this therapy has evolved over the past decade...
April 2018: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/29555655/blood-pressure-management-in-older-people-balancing-the-risks
#3
REVIEW
Jochanan E Naschitz
Guidelines of arterial hypertension treatment based on individualised expected outcomes are not available for frail older persons. In this paper, we review the evidence, concerning management of arterial blood pressure (BP) in frail older patients. We focused on the best affordable methods for BP measurement; the age-related optimum BP; specific BP goals in agreement with the patients' general heath, frailty status, orthostatic and postprandial hypotension; balancing the benefits against risks of antihypertensive treatment...
March 19, 2018: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/29397348/-resistant-hypertension-an-update
#4
N F Renna
An estimated 10% to 20% of hypertensive patients could be considered resistant to treatment (RH). These are patients who are not controlled using three drugs, at the maximum tolerated doses, including a diuretic, as well as those with high blood pressure controlled using four or more drugs. The term is used to identify patients that might benefit from special diagnostic and/or therapeutic consideration. The term 'refractory hypertension' has recently been proposed as a novel phenotype of antihypertensive failure...
February 4, 2018: Hipertensión y Riesgo Vascular
https://www.readbyqxmd.com/read/29357392/prevention-detection-evaluation-and-management-of-high-blood-pressure-in-adults-synopsis-of-the-2017-american-college-of-cardiology-american-heart-association-hypertension-guideline
#5
Robert M Carey, Paul K Whelton
Description: In November 2017, the American College of Cardiology (ACC) and the American Heart Association (AHA) released a clinical practice guideline for the prevention, detection, evaluation, and treatment of high blood pressure (BP) in adults. This article summarizes the major recommendations. Methods: In 2014, the ACC and the AHA appointed a multidisciplinary committee to update previous reports of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure...
March 6, 2018: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29214027/to-what-extent-do-prescribing-practices-for-hypertension-in-the-private-sector-in-zimbabwe-follow-the-national-treatment-guidelines-an-analysis-of-insurance-medical-claims
#6
Victor Basopo, Paschal N Mujasi
Background: Hypertension is the most prevalent cardiovascular disease in Zimbabwe. The prevalence of Hypertension in the country is above 30% regardless of the cut off used. Currently, majority of patients in Zimbabwe seek health care from the private sector due to limited government funding for the public health sector. However, Standard treatment guidelines for hypertension are only available in the public sector and are optional in the private sector. This study assesses compliance of private sector prescribing to Standard Treatment guidelines for hypertension...
2017: Journal of Pharmaceutical Policy and Practice
https://www.readbyqxmd.com/read/29207946/achieved-systolic-blood-pressure-in-older-people-a-systematic-review-and-meta-analysis
#7
Aline A I Moraes, Cristina P Baena, Taulant Muka, Arjola Bano, Adriana Buitrago-Lopez, Ana Zazula, Bruna O Erbano, Nicolle A Schio, Murilo H Guedes, Wichor M Bramer, Oscar H Franco, José Rocha Faria-Neto
BACKGROUND: It remains unclear into which level the systolic blood pressure (SBP) should be lowered in order to provide the best cardiovascular protection among older people. Hypertension guidelines recommendation on attaining SBP levels <150 mmHg in this population is currently based on experts' opinion. To clarify this issue, we systematically reviewed and quantified available evidence on the impact of achieving different SBP levels <150 mmHg on various adverse outcomes in subjects aged ≥60 years old receiving antihypertensive drug treatment...
December 5, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/29080925/the-role-of-sympatho-inhibition-in-combination-treatment-of-obesity-related-hypertension
#8
REVIEW
Revathy Carnagarin, Cynthia Gregory, Omar Azzam, Graham S Hillis, Carl Schultz, Gerald F Watts, Damon Bell, Vance Matthews, Markus P Schlaich
Obesity-related hypertension is commonly characterized by increased sympathetic nerve activity and is therefore acknowledged as a predominantly neurogenic form of hypertension. The sustained sympatho-excitation not only contributes to the rise in blood pressure but also elicits a vicious cycle which facilitates further weight gain and progression of associated co-morbidities. While weight loss and exercise remain at the forefront of therapy for obesity and obesity-related hypertension, the difficulties in achieving and maintaining long-term weight loss with lifestyle measures and the variable blood pressure response to weight loss often necessitate prescription of antihypertensive drug therapy...
October 28, 2017: Current Hypertension Reports
https://www.readbyqxmd.com/read/28911302/what-is-the-real-efficacy-of-beta-blockers-for-the-treatment-of-essential-hypertension
#9
Christian Hocht, Facundo M Bertera, Julieta S Del Mauro, Yanina Santander Plantamura, Carlos A Taira, Ariel H Polizio
OBJECTIVE: This review covers the pharmacokinetics and pharmacodynamic of β-blockers, the rationale for their use, some recent controversies in its use for managing hypertension, as well as, the beneficial properties of the third-generation β-blockers beyond hypertension. BACKGROUND: The efficacy and safety of β-blockers in the treatment of hypertension and other cardiovascular diseases have been established during more than 50 years of clinical experience. Recent updates of clinical guidelines have downgraded the use of β-blockers for the treatment of uncomplicated hypertension to second and third line therapy...
2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28711167/perioperative-management-of-hypertensive-neuroblastoma-a-study-from-the-italian-group-of-pediatric-surgical-oncologists-gicop
#10
Luca Pio, Stefano Avanzini, Girolamo Mattioli, Giuseppe Martucciello, Angela Rita Sementa, Massimo Conte, Annarita Gigliotti, Claudio Granata, Ernesto Leva, Anna Maria Fagnani, Umberto Caccioppoli, Nino Tedesco, Jurgen Schleef, Elisa Tirtei, Fortunato Siracusa, Paolo D'Angelo, Pierluigi Lelli Chiesa, Lucia Miglionico, Bruno Noccioli, Elisa Severi, Claudio Carlini, Francesco Vaccarella, Francesco Camoglio, Simone Cesaro, Alessandra Narciso, Giovanna Riccipetitoni, Giovanni Cecchetto, Alessandro Inserra
BACKGROUND: Hypertension (HT) is rarely reported in patients affected by Neuroblastoma (NB), and management guidelines are lacking. Clinical features and perioperative medical treatment in such patients were reviewed to 1) ascertain whether a shared treatment strategy exists among centers and 2) if possible, propose some recommendations for the perioperative management of HT in NB patients. METHODS: A retrospective multicenter survey was conducted on patients affected by NB who presented HT symptoms...
July 3, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28685623/cardiovascular-disease-prevention-strategies-for-type-2-diabetes-mellitus
#11
REVIEW
Niki Katsiki, Francesco Purrello, Costas Tsioufis, Dimitri P Mikhailidis
Type 2 diabetes mellitus (T2DM) is associated with several cardiovascular (CV) risk factors such as insulin resistance, obesity, hypertension, dyslipidaemia, non-alcoholic fatty liver disease as well as platelet and haemostatic abnormalities increasing the risk of thrombosis. Therefore, T2DM patients are at an increased risk for CV disease (CVD). Areas covered: This narrative review discusses the treatment of T2DM. This includes lifestyle measures (diet, exercise and smoking cessation) as well as hypolipidaemic, antihypertensive, weight reducing, antiplatelet and glucose lowering drugs...
August 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28553650/recent-treatment-advances-and-new-trials-in-adult-nephrotic-syndrome
#12
REVIEW
Eva Königshausen, Lorenz Sellin
The etiology of nephrotic syndrome is complex and ranges from primary glomerulonephritis to secondary forms. Patients with nephrotic syndrome often need immunosuppressive treatment with its side effects and may progress to end stage renal disease. This review focuses on recent advances in the treatment of primary causes of nephrotic syndrome (idiopathic membranous nephropathy (iMN), minimal change disease (MCD), and focal segmental glomerulosclerosis (FSGS)) since the publication of the KDIGO guidelines in 2012...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28482060/unsuccessfully-treated-hypertension-a-major-public-health-problem-with-a-potential-solution
#13
Curt D Furberg, Jean E Sealey, Jon D Blumenfeld
BACKGROUND: About one-half of all hypertensive adults do not have their blood pressure controlled. They are often prescribed medications that conform to national guidelines but they continue to have elevated blood pressure. This public health problem might be improved by applying plasma renin guided therapy. RESULTS: A contributor to the public health problem of unsuccessfully treated hypertension is that the circulating renin-angiotensin system (RAS) is not recognized in treatment guidelines as clinically relevant for the treatment of hypertension or as important as the body salt status for determining blood pressure levels...
September 1, 2017: American Journal of Hypertension
https://www.readbyqxmd.com/read/28449829/hypertension-canada-s-2017-guidelines-for-the-diagnosis-assessment-prevention-and-treatment-of-pediatric-hypertension
#14
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/28349377/preferred-fourth-line-pharmacotherapy-for-resistant-hypertension-are-we-there-yet
#15
REVIEW
Hamish Cg Prosser, Cynthia Gregory, Dagmara Hering, Graham S Hillis, Greg Perry, Johan Rosman, Carl Schultz, Mark Thomas, Gerald F Watts, Markus P Schlaich
Resistant hypertension (RH) is defined as blood pressure (BP) that remains above target levels despite adherence to at least three different antihypertensive medications, typically including a diuretic. Epidemiological studies estimate that RH is increasing in prevalence, and is associated with detrimental health outcomes. The pathophysiology underlying RH is complex, involving multiple, overlapping contributors including activation of the renin-angiotensin aldosterone system and the sympathetic nervous system, volume overload, endothelial dysfunction, behavioural and lifestyle factors...
April 2017: Current Hypertension Reports
https://www.readbyqxmd.com/read/28181201/management-of-hypertension-in-the-elderly-and-frail-elderly
#16
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...
March 2017: High Blood Pressure & Cardiovascular Prevention: the Official Journal of the Italian Society of Hypertension
https://www.readbyqxmd.com/read/28157821/blood-pressure-control-for-acute-severe-ischemic-and-hemorrhagic-stroke
#17
Julian Bösel
PURPOSE OF REVIEW: Severe ischemic or hemorrhagic stroke is a devastating cerebrovascular disease often demanding critical care. Optimal management of blood pressure (BP) in the acute phase is controversial. The purpose of this review is to display insights from recent studies on BP control in both conditions. RECENT FINDINGS: BP control in acute ischemic stroke has recently been investigated with regard to endovascular recanalizing therapies. Decreases from baseline BP and hypotension during the intervention have been found detrimental...
April 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28129695/are-two-drugs-better-than-one-a-review-of-combination-therapies-for-hypertension
#18
REVIEW
Yogita Rochlani, Mohammed Hasan Khan, Maciej Banach, Wilbert S Aronow
Current guidelines for pharmacotherapy briefly describe a role for combination antihypertensive therapy. However, guidance on whether combination therapy should be used at the time of initiating therapy or as add on, and the choice of combination therapy is scarce. Areas covered: Current literature suggests that intensive blood pressure control is the key to managing cardiovascular risk. Along with lifestyle management, pharmacotherapy is an central component in the treatment of hypertension. Here, we aim to review the pathophysiology of hypertension, rationale for using combination therapy, and the different combinations of antihypertensive drug classes that are available in the market...
March 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28004328/management-of-acute-hypertensive-response-in-intracerebral-hemorrhage-patients-after-atach-2-trial
#19
Shahram Majidi, Jose I Suarez, Adnan I Qureshi
Acute hypertensive response is elevation of systolic blood pressure (SBP) in the first 24 h after symptom onset which is highly prevalent in patients with intracerebral hemorrhage (ICH). Observational studies suggested association between acute hypertensive response and hematoma expansion, peri-hematoma edema and death and disability, and possible reduction in these adverse outcomes with treatment of acute hypertensive response. Recent clinical trials have focused on determining the clinical efficacy of early intensive SBP reduction in ICH patients...
October 2017: Neurocritical Care
https://www.readbyqxmd.com/read/27957711/the-role-of-beta-blockers-in-the-treatment-of-hypertension
#20
REVIEW
John M Cruickshank
IMPORTANCE: Two major guide-line committees (JNC-8 and NICE UK) have dropped beta-blockers as first-line therapy in the treatment of hypertension. Also, recent meta-analyses (that do not take age into account) have concluded that beta-blockers are inappropriate first-line agents in the treatment of hypertension. This review seeks to shed some light on the "rights and wrongs" of such actions and conclusions. OBJECTIVES: Because the pathophysiology of primary/essential hypertension differs in elderly and younger subjects, the latter being closely linked to obesity and increased sympathetic nerve activity, the author sought to clarify the efficacy of beta-blockers in the younger/middle-aged group in reducing the risk of death, and cardiovascular end-points...
2017: Advances in Experimental Medicine and Biology
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