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Antihypertensives treatment guideline review

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https://www.readbyqxmd.com/read/29080925/the-role-of-sympatho-inhibition-in-combination-treatment-of-obesity-related-hypertension
#1
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
#2
Christian Höcht, 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 -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 -blockers for the treatment of uncomplicated hypertension to second and third line therapy...
June 7, 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
#3
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
#4
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
#5
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
#6
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-%C3%A2-assessment-prevention-and-treatment-of%C3%A2-pediatric-hypertension
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
https://www.readbyqxmd.com/read/27919826/should-blood-pressure-goal-be-individualized-in-hypertensive-patients
#14
REVIEW
Alexandra Yannoutsos, Rania Kheder-Elfekih, Jean-Michel Halimi, Michel E Safar, Jacques Blacher
The aim of the present review is to consider the clinical relevance of individualized blood pressure (BP) goal under treatment in hypertensive patients according to their age, comorbidities or established cardiovascular (CV) disease. Evidence from large-scale randomized trials to support a lower BP goal, as initially recommended by guidelines in high-risk hypertensive patients, were lacking. Recently, the randomized intervention SPRINT trial studied two treatment targets for systolic BP (120mm Hg versus 140mm Hg in the intensive and standard treatment group, respectively) among high-risk hypertensive patients, without diabetes and without a history of prior stroke...
April 2017: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/27771852/threshold-and-target-for-blood-pressure-lowering-in-the-elderly
#15
REVIEW
Guido Grassi, Fosca Quarti-Trevano, Anna Casati, Raffaella Dell'Oro
PURPOSE OF REVIEW: Detection of elevated blood pressure values in elderly patients represents a common clinical condition associated with an increased cardiovascular risk. This has been shown to be the case in both systodiastolic and isolated systolic hypertension as well. However, despite the evidence of the benefits of the blood pressure lowering intervention in terms of reduction of cardiovascular morbidity and mortality, at least two issues related to antihypertensive drug treatment in aged individuals are still undefined: (1) the blood pressure threshold at which antihypertensive drug should be initiated and (2) the blood pressure goals of the therapeutic intervention...
December 2016: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/27754014/me-02-3-extending-sprint-results-to-diabetics
#16
Guido Grassi
The Systolic Blood Pressure Intervention Trial (SPRINT), sponsored by the National Heart, Lung and Blood Institute in the USA, allocated 9361 hypertensive patients (mean age 68 years) to two systolic blood pressure treatment targets (either < 120mmHg or < 140mmHg). Although SPRINT intended to enrol hypertensive patients at high cardiovascular risk, it specifically excluded patients with diabetes mellitus or prior stroke. SPRINT was stopped earlier than planned, after a mean follow-up of 3.26 years, on the recommendation of its data and safety monitoring board, and data were published on 9 November 2015...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27754012/me-02-1-is-lower-really-better-issue-of-the-j-curve-hypothesis-in-hypertension
#17
Bo Carlberg
The J curve hypothesis propose that the relation between blood pressure and risk for cardiovascular events is non-linear. Instead of a decreased risk with lower blood pressure, the risk increases at lower blood pressures. This issue has been discussed for many years, and is still a hot topic. The debates have most often had its origin in the question about how far blood pressure should be lowered with antihypertensive drugs.One one hand, we know that many patients with hypertension is not treated to targets according to guidelines and that this contributes to the high risk for cardiovascular diseases in patients with hypertension...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27753820/pl-01-1-cardiovascular-protection-in-hypertension-which-targets-for-treatment
#18
Giuseppe Mancia
A huge amount of evidence is available that antihypertensive treatment is accompanied by a reduction in the risk of cardiovascular (CV) and renal outcomes as well as that a major portion of the beneficial effect is due to blood pressure (BP) lowering per se, regardless how it is obtained. Despite decades of research, however, information is still not conclusive on which might be the BP values to achieve with treatment in order to maximize CV and renal protection. This presentation will address this issue by reviewing the current target BP values recommended by guidelines in the general and elderly hypertensive population with a description of the related evidence...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27690353/fixed-dose-versus-separate-drug-combinations-for-antihypertensive-treatment-literature-review
#19
José Luis Calleja Rivero, Franklin Zerpa, Loreto Rivera
INTRODUCTION: Hypertension requires effective interventions to reduce cardiovascular morbidity and mortality. Drug therapies have achieved optimal blood pressure levels in affected patients. Recent clinical guidelines suggest drug combinations a fact that has led to the development of various fixed-dose combinations. OBJECTIVE: To find the best available evidence about the effectiveness of antihypertensive drugs in fixed-dose combinations compared with separate dose combinations for blood pressure control, treatment adherence and reducing cardiovascular morbidity and mortality...
2016: Medwave
https://www.readbyqxmd.com/read/27689239/treatment-options-for-hypertension-in-pregnancy-and-puerperium
#20
REVIEW
Farah H Amro, Hind N Moussa, Olaide A Ashimi, Baha M Sibai
Hypertensive disorders have become increasingly prevalent and complicate an increasing number of pregnancies. Therefore it is essential that the medications used to treat these disorders be well understood. Furthermore the management is complicated by special consideration needed for the physiologic changes of pregnancy as well as the consideration for possible adverse fetal effects. Areas covered: We performed a review of the scientific literature of medications used to treat hypertensive disorders in pregnancy...
December 2016: Expert Opinion on Drug Safety
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